Active NPI
Khushbu Ketan Patel, DMD
- General Practice Dentistry
- Wilmington, DE
National Provider Identifier
1336882802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- G1-0011563
- Practice address
- 501 W 14TH St
Wilmington, DE 19801-1013 - Phone
- (302) 733-1043
- NPI assigned
- Apr 13, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | G1-0011563 | DE | Primary |
Addresses
Primary practice location
501 W 14TH St
Wilmington, DE 19801-1013
Mailing address
1211 Milltown Rd
Wilmington, DE 19808-3003
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220621001113 | DE | Order and Referring Only - Dentist | 6709265804 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G1-0011563 | DE | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1336882802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211 MILLTOWN RD",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198083003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 W 14TH ST",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198011013",
"telephone_number": "302-733-1043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "KHUSHBU",
"middle_name": "KETAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-13",
"last_updated": "2023-09-11",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "DE",
"license": "G1-0011563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.