Individual provider Active NPI

Hetal Patel, DMD

  • Pediatric Dentistry
  • Hamilton, NJ
National Provider Identifier
1255798781
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DI02677800 Issued in NJ
Practice address
312 Route 33
Hamilton, NJ 08619
Phone
(609) 228-3200
NPI assigned
Jan 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X DI02677800 NJ Primary

Addresses

Primary practice location

312 Route 33
Hamilton, NJ 08619

Mailing address

405 Arnold Dr
Florence, NJ 08518-4005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20190315001679 NJ Order and Referring Only - DentistPractitioner - Dentist 0244570950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI02677800NJMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1255798781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 ARNOLD DR",
            "city": "FLORENCE",
            "state": "NJ",
            "postal_code": "085184005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 ROUTE 33",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "08619",
            "telephone_number": "609-228-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "HETAL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "DI02677800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, NJ

Sources for this page

Verify at the official NPI Registry.