Active NPI
Manali Diviesh Patel, DDS
- Dentist
- Flint, MI
National Provider Identifier
1356025241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901601783
- Practice address
- 4021 Miller Rd
Flint, MI 48507-1231 - Phone
- (810) 515-8952
- NPI assigned
- Jun 12, 2023
- Last updated
- Jun 12, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2901601783 | MI | Primary |
Addresses
Primary practice location
4021 Miller Rd
Flint, MI 48507-1231
Mailing address
2719 Hawthorne Dr S
Shelby Township, MI 48316-6102
Phone (586) 453-8732
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 |
|---|---|---|---|
| 2901601783 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686528000000",
"number": "1356025241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2719 HAWTHORNE DR S",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483166102",
"telephone_number": "586-453-8732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4021 MILLER RD",
"city": "FLINT",
"state": "MI",
"postal_code": "485071231",
"telephone_number": "810-515-8952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "MANALI",
"middle_name": "DIVIESH",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-12",
"last_updated": "2023-06-12",
"certification_date": "2023-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901601783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.