Individual provider Active NPI

Tushar B Patel, D.D.S.

  • Endodontics
  • San Dimas, CA
National Provider Identifier
1164630919
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
49180 Issued in CA
Practice address
1301 W Arrow Hwy Ste 110
San Dimas, CA 91773-2330
Phone
(909) 394-5500
Fax
(909) 394-7700
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 49180 CA Primary

Addresses

Primary practice location

1301 W Arrow Hwy Ste 110
San Dimas, CA 91773-2330

Mailing address

1301 W Arrow Hwy Ste 110
San Dimas, CA 91773-2330
Phone (909) 394-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1164630919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W ARROW HWY STE 110",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732330",
            "telephone_number": "909-394-5500",
            "fax_number": "909-394-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W ARROW HWY STE 110",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732330",
            "telephone_number": "909-394-5500",
            "fax_number": "909-394-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "TUSHAR",
        "middle_name": "B",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "49180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.