Individual provider Active NPI

Mayur Kanubhai Dudhat, DDS

  • Dentist
  • Allentown, PA
National Provider Identifier
1407424393
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS043193 Issued in PA
Practice address
501 N 17TH St Ste 107
Allentown, PA 18104-5044
Phone
(304) 508-8588
NPI assigned
Jun 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DS043193 PA Primary

Addresses

Primary practice location

501 N 17TH St Ste 107
Allentown, PA 18104-5044

Mailing address

107 Westminster Dr
North Wales, PA 19454-1218
Phone (304) 508-8588

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

LicenseStateTypeSpecialty
DS043193PAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1407424393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WESTMINSTER DR",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194541218",
            "telephone_number": "304-508-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N 17TH ST STE 107",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181045044",
            "telephone_number": "304-508-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDHAT",
        "first_name": "MAYUR",
        "middle_name": "KANUBHAI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS043193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.