Individual provider Active NPI

Kunal Narottambhai Patel, D.M.D.

  • General Practice Dentistry
  • Waterbury, CT
National Provider Identifier
1245542620
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
010292 Issued in CT
Practice address
155 Thomaston Ave # C12
Waterbury, CT 06702-1020
Phone
(203) 575-9944
NPI assigned
Jul 13, 2010
Last updated
Aug 29, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 010292 CT
General Practice Dentistry 1223G0001X 010292 CT Primary

Addresses

Primary practice location

155 Thomaston Ave # C12
Waterbury, CT 06702-1020

Mailing address

100 Jefferson SQ Apt 7D
Waterbury, CT 06706-1136
Phone (617) 320-2706

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

State licenses

LicenseStateTypeSpecialty
010292CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Stamford Dental Care PLLC General Practice Current Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1245542620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 JEFFERSON SQ APT 7D",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061136",
            "telephone_number": "617-320-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 THOMASTON AVE # C12",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021020",
            "telephone_number": "203-575-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KUNAL",
        "middle_name": "NAROTTAMBHAI",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-13",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "010292",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.