Individual provider Active NPI

Nimesh L. Patel, DMD

  • General Practice Dentistry
  • Glastonbury, CT
National Provider Identifier
1164539342
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
007785 Issued in CT
Practice address
2450 Main St
Glastonbury, CT 06033-2041
Phone
(860) 633-6246
Fax
(860) 633-1808
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 007785 CT Primary

Addresses

Primary practice location

2450 Main St
Glastonbury, CT 06033-2041

Mailing address

2450 Main St
Glastonbury, CT 06033-2041
Phone (860) 633-6246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20150528002158 CT Order and Referring Only - DentistPractitioner - Dentist 0446570659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007785CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mandell & Blau, MD'S PC Past Accepting new patients
Glastonbury Family Dental General Practice Past Accepting new patients

Organizations & group practices 2

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164539342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 MAIN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332041",
            "telephone_number": "860-633-6246",
            "fax_number": "860-633-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 MAIN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332041",
            "telephone_number": "860-633-6246",
            "fax_number": "860-633-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIMESH",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "007785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.