Individual provider Active NPI

M. B. Patel, DDS

  • General Practice Dentistry
  • Ventura, CA
National Provider Identifier
1215920947
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31354 Issued in CA
Practice address
4080 Loma Vista Rd
Suite # C
Ventura, CA 93003-1811
Phone
(805) 642-5808
Fax
(805) 642-5052
NPI assigned
Aug 29, 2005
Last updated
Jul 8, 2007By the provider in NPPES
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 31354 CA Primary

Addresses

Primary practice location

4080 Loma Vista Rd
Suite # C
Ventura, CA 93003-1811

Mailing address

4080 Loma Vista Rd
Suite # C
Ventura, CA 93003-1811
Phone (805) 642-5808

Other identifiers 1

IdentifierTypeStateIssuer
B31354-01OtherCADENTI-CAL

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215920947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 LOMA VISTA RD",
            "address_2": "SUITE # C",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031811",
            "telephone_number": "805-642-5808",
            "fax_number": "805-642-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 LOMA VISTA RD",
            "address_2": "SUITE # C",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031811",
            "telephone_number": "805-642-5808",
            "fax_number": "805-642-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "M.",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "B31354-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.