Individual provider Active NPI

Mitali Y Patel, DDS

  • Pediatric Dentistry
  • Atlanta, GA
National Provider Identifier
1316273659
Registry record updated Dec 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN122885 Issued in GA
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

Updated by the provider on Dec 4, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
019.028075ILMDDentist
DEN1001183DCMDPediatric Dentist
DN122885GAMDPediatric Dentist
15160MDMDPediatric Dentist
0401414403VAMDPediatric 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.

Verify at the official NPI Registry.