Individual provider Active NPI

Jesal Arun Patel, DDS

  • General Practice Dentistry
  • Fairfield TWP, OH
National Provider Identifier
1265523187
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30021009 Issued in OH
Practice address
3500 Siaron Way
Fairfield TWP, OH 45011
Phone
(513) 815-3166
Fax
(513) 829-5499
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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 30021009 OH Primary

Addresses

Primary practice location

3500 Siaron Way
Fairfield TWP, OH 45011

Mailing address

3500 Siaron Way
Fairfield TWP, OH 45011
Phone (513) 815-3166

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
30021009OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Shawn a Dornhecker DDS & Jesal a Patel DDS Inc General Practice CurrentSince Mar 1, 2020 Accepting new patients

Locations

1251 Nilles Rd
Ste 20
Fairfield, OH 45014
Phone (513) 341-8291

3500 Siaron Way
Fairfield Twp, OH 45011
Phone (513) 815-3166

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1265523187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 SIARON WAY",
            "city": "FAIRFIELD TWP",
            "state": "OH",
            "postal_code": "45011",
            "telephone_number": "513-815-3166",
            "fax_number": "513-829-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 SIARON WAY",
            "city": "FAIRFIELD TWP",
            "state": "OH",
            "postal_code": "45011",
            "telephone_number": "513-815-3166",
            "fax_number": "513-829-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JESAL",
        "middle_name": "ARUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30021009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield TWP, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.