Bhavik Nilesh Patel, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2021000611 Issued in MO

Practice address

2226 Missouri Blvd
Jefferson City, MO 65109-4727

Phone

(573) 658-4022

NPI assigned

Jan 8, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Formanek DDS LLC

  • General Practice Dentistry
  • Jefferson City, MO
  • NPI 1508355900
  NPD (past)

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1396333969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4331 KENTSFIELD LN APT 203",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652013648",
            "telephone_number": "720-487-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 MISSOURI BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651094727",
            "telephone_number": "573-658-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "BHAVIK",
        "middle_name": "NILESH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2021000611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vickie Jean Park, MD
• Derek Scott Parker, PT
• Jordan Elizabeth Parker, MD
• Ashlee Kathleen Parkes, FNP
• Elena Parr
• Hemal Yogesh Patel, MD
• Shefali P Patel
• Patient Care Inc.
• Jeffrey P. Patrick, M.D.
• Adam Clay Patterson, MD

• Dentist in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.