Individual provider Active NPI

Jay Patel, D.M.D.

  • Dentist
  • Manassas, VA
National Provider Identifier
1336554013
Registry record updated Jun 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401414475 Issued in VA
Practice address
7409 Silent Willow CT
Manassas, VA 20112-5550
Phone
(703) 794-9946
NPI assigned
Jun 21, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401414475 VA Primary

Addresses

Primary practice location

7409 Silent Willow CT
Manassas, VA 20112-5550

Mailing address

7409 Silent Willow CT
Manassas, VA 20112-5550
Phone (703) 794-9946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20160623001792 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9335430214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401414475VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1403308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403308800000",
    "number": "1336554013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7409 SILENT WILLOW CT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201125550",
            "telephone_number": "703-794-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7409 SILENT WILLOW CT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201125550",
            "telephone_number": "703-794-9946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JAY",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-21",
        "last_updated": "2014-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.