Individual provider Active NPI

Ravi A Patel, DMD

  • Dentist
  • Buford, GA
National Provider Identifier
1326486333
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN014601 Issued in GA
Practice address
4536 Nelson Brogdon Blvd BLDG a
Buford, GA 30518-7516
Phone
(678) 730-2005
Fax
(678) 730-2008
NPI assigned
Jun 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN014601 GA Primary

Addresses

Primary practice location

4536 Nelson Brogdon Blvd BLDG a
Buford, GA 30518-7516

Mailing address

4536 Nelson Brogdon Blvd BLDG a
Buford, GA 30518-7516
Phone (678) 730-2005

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
DN014601GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ram Dental, LLC CurrentSince Jan 26, 2022 Accepting new patients
Roam Dental Appliances LLC Dentist CurrentSince Jan 26, 2022 Accepting new patients

Locations

4536 Nelson Brogdon Blvd
Bldg A
Buford, GA 30518
Phone (678) 730-2005

4700 Nelson Brogdon Blvd
Ste 210
Buford, GA 30518
Phone (470) 412-5455

Organizations & group practices 2

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": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1326486333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4536 NELSON BROGDON BLVD BLDG A",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305187516",
            "telephone_number": "678-730-2005",
            "fax_number": "678-730-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4536 NELSON BROGDON BLVD BLDG A",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305187516",
            "telephone_number": "678-730-2005",
            "fax_number": "678-730-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RAVI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.