Individual provider Active NPI

Karishma Patil, BDS, MSD

  • Endodontics
  • Dallas, TX
National Provider Identifier
1265984470
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
36687 Issued in TX
Practice address
5925 Forest LN Ste 314
Dallas, TX 75230-2775
Phone
(469) 416-7084
NPI assigned
Nov 4, 2016
Last updated
Oct 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 36687 TX Primary

Addresses

Primary practice location

5925 Forest LN Ste 314
Dallas, TX 75230-2775

Mailing address

4880 N President George Bush Hwy Ste 102
Garland, TX 75040-2742
Phone (972) 496-0164

Other practice location 1

4880 N President George Bush Hwy Ste 102
Garland, TX 75040-2742
Phone (469) 416-7084

Other practice location 2

2840 Keller Springs Rd Ste 703
Carrollton, TX 75006-4874
Phone (214) 483-3660

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
36687TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Endodontic Specialists, PLLC Endodontics CurrentSince Aug 18, 2024 Accepting new patients
Texasendodonticsp.C. Endodontics Past Accepting new patients
The Endodontic Specialists, PLLC Endodontics PastSince Oct 11, 2020 Accepting new patients
Modern Texas Dental Specialties Past Accepting new patients

Locations

4880 N President George Bush Hwy
Ste 102
Garland, TX 75040
Phone (469) 416-7084

Organizations & group practices 4

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": "1478217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1265984470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4880 N PRESIDENT GEORGE BUSH HWY STE 102",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750402742",
            "telephone_number": "972-496-0164",
            "fax_number": "972-295-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 FOREST LN STE 314",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302775",
            "telephone_number": "469-416-7084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4880 N President George Bush Hwy Ste 102",
            "address_purpose": "LOCATION",
            "city": "Garland",
            "state": "TX",
            "postal_code": "750402742",
            "country_code": "US",
            "telephone_number": "469-416-7084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2840 Keller Springs Rd Ste 703",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "TX",
            "postal_code": "750064874",
            "country_code": "US",
            "telephone_number": "214-483-3660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATIL",
        "first_name": "KARISHMA",
        "name_prefix": "Dr.",
        "credential": "BDS, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-04",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "36687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.