Kaelan Patel, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11845 Issued in OR

Practice address

2905 SW Cedar Hills Blvd Ste 120
Beaverton, OR 97005-1471

Phone

(503) 396-4071

NPI assigned

Jul 13, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Cedar Hills Modern Dentistry, PC

  • General Practice Dentistry
  • Beaverton, OR
  • NPI 1043724917
  NPD (past)

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1285313577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10736 NW GLENMORE WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972294082",
            "telephone_number": "503-720-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 SW CEDAR HILLS BLVD STE 120",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051471",
            "telephone_number": "503-396-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KAELAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennie Rowe Parmelee
• Ruth Parra Santana, CADC-I, CGAC-R, CRM
• Kathryn Parsons, CADC1
• Andrea Vanessa Passano
• Aman Patel, PHARMD
• Lisa Patenode, DC
• Chelsea Nicole Paterson, APRN-CNP
• Dharmini Pathmanathan, DMD, PHD
• Shilpa Patil
• Megan Patten, LMT

• General Practice Dentistry in Beaverton, OR
• Providers in Beaverton, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.