Active NPI
Divyesh R Patel, DMD
- General Practice Dentistry
- Mililani, HI
National Provider Identifier
1396177903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2552
- Practice address
- 95-1249 Meheula Pkwy Ste 115
Mililani, HI 96789-1786 - Phone
- (551) 580-2016
- NPI assigned
- Aug 6, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 29363 | TX | |
| General Practice Dentistry | 1223G0001X | 2552 | HI | Primary |
Addresses
Primary practice location
95-1249 Meheula Pkwy Ste 115
Mililani, HI 96789-1786
Mailing address
284 Bougainvillea Loop
Honolulu, HI 96818-4123
Phone (551) 580-2016
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29363 | TX | MD | Pharmacist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415059200000",
"number": "1396177903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 BOUGAINVILLEA LOOP",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968184123",
"telephone_number": "551-580-2016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95-1249 MEHEULA PKWY STE 115",
"city": "MILILANI",
"state": "HI",
"postal_code": "967891786",
"telephone_number": "551-580-2016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "DIVYESH",
"middle_name": "R",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-06",
"last_updated": "2014-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "29363",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "HI",
"license": "2552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mililani, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.