Individual provider Active NPI

Hiren Patel

  • Pediatric Dentistry
  • Peoria, AZ
National Provider Identifier
1255418174
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
8085 Issued in AZ
Practice address
8085 W Bell Rd
Suite 103
Peoria, AZ 85382-3825
Phone
(623) 486-5430
Fax
(623) 878-6467
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401411556 VA
Pediatric Dentistry 1223P0221X 8085 AZ Primary

Addresses

Primary practice location

8085 W Bell Rd
Suite 103
Peoria, AZ 85382-3825

Mailing address

3935 E Rough Rider Rd
#1024
Phoenix, AZ 85050-7346
Phone (804) 536-5169

Other identifiers 2

IdentifierTypeStateIssuer
548413OtherAZAHCCCS
9183735MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150901002637 AZ Order and Referring Only - DentistPractitioner - Dentist 6103132402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401411556VAMDGeneral Practice Dentistry
8085AZMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Arrowhead Dental Group and Orthodontics, LLP General Practice Past Accepting new patients
Az Children'S Dental Care PLLC Pediatric Dentistry 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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1255418174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3935 E ROUGH RIDER RD",
            "address_2": "#1024",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850507346",
            "telephone_number": "804-536-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8085 W BELL RD",
            "address_2": "SUITE 103",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823825",
            "telephone_number": "623-486-5430",
            "fax_number": "623-878-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "HIREN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411556",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "8085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "548413",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9183735",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.