Active NPI
Mitali Y Patel, DDS
- Pediatric Dentistry
- Atlanta, GA
National Provider Identifier
1316273659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN122885
- Practice address
- 1213 Dalon Rd NE Ste 102
Atlanta, GA 30306-2024 - Phone
- (404) 418-6684
- NPI assigned
- Oct 21, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.028075 | IL | |
| Pediatric Dentistry | 1223P0221X | 15160 | MD | |
| Pediatric Dentistry | 1223P0221X | DEN1001183 | DC | |
| Pediatric Dentistry | 1223P0221X | 0401414403 | VA | |
| Pediatric Dentistry | 1223P0221X | DN122885 | GA | Primary |
Addresses
Primary practice location
1213 Dalon Rd NE Ste 102
Atlanta, GA 30306-2024
Mailing address
3527 Ambassador Aly
Scottdale, GA 30079-5609
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.028075 | IL | MD | Dentist |
| DEN1001183 | DC | MD | Pediatric Dentist |
| DN122885 | GA | MD | Pediatric Dentist |
| 15160 | MD | MD | Pediatric Dentist |
| 0401414403 | VA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670112000000",
"number": "1316273659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3527 AMBASSADOR ALY",
"city": "SCOTTDALE",
"state": "GA",
"postal_code": "300795609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1213 DALON RD NE STE 102",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303062024",
"telephone_number": "404-418-6684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "MITALI",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-21",
"last_updated": "2022-12-04",
"certification_date": "2022-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.028075",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MD",
"license": "15160",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "DC",
"license": "DEN1001183",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "VA",
"license": "0401414403",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "GA",
"license": "DN122885",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.