Individual provider Active NPI

Ujwal Vinubhai Patel

  • Dentist
  • Fort Wayne, IN
National Provider Identifier
1144064213
Registry record updated Jan 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12014768A Issued in IN
Practice address
1717 S Calhoun St
Fort Wayne, IN 46802-5257
Phone
(260) 458-2641
NPI assigned
Jun 24, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12014768A IN Primary

Addresses

Primary practice location

1717 S Calhoun St
Fort Wayne, IN 46802-5257

Mailing address

1717 S Calhoun St
Fort Wayne, IN 46802-5257

Other practice location 1

160 Robbins St Ste 200
Waterbury, CT 06708-2652
Phone (203) 757-8855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251015000313 IN Practitioner - Dentist 7315434164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
State University of New York at Buffalo School of Medicine, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1717 S Calhoun St
Fort Wayne, IN 46802-5257

6619 Brotherhood Way
Fort Wayne, IN 46825-4226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12014768AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health Clinics, Inc Single Specialty CurrentSince Sep 12, 2025 Accepting new patients
Spectra Dental LLC Single Specialty CurrentSince Aug 18, 2024 Accepting new patients
Neighborhood Health Clinics, Inc CurrentSince Sep 12, 2025 Accepting new patients
Prospect CT Medical Foundation, Inc. Single Specialty PastSince Aug 18, 2024 Accepting new patients

Locations

160 Robbins St
Waterbury, CT 06708
Phone (203) 573-7284

160 Robbins St
Ste 200
Waterbury, CT 06708
Phone (203) 757-8855

1717 S Calhoun St
Fort Wayne, IN 46802
Phone (260) 458-2641

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768608000000",
    "number": "1144064213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468025257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468025257",
            "telephone_number": "260-458-2641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Robbins St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067082652",
            "country_code": "US",
            "telephone_number": "203-757-8855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "UJWAL",
        "middle_name": "VINUBHAI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-24",
        "last_updated": "2026-01-17",
        "certification_date": "2026-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12014768A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.