NPIMap

Kajal Joshi, DMD

Individual provider Active NPI Pediatric Dentistry · Wheaton, IL

NPI 1487928941 · NPPES record last updated Sep 28, 2021

Key facts

NPI
1487928941
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
021002604 (IL)
Practice address
722 S President St
Wheaton, IL 60189
Phone
(630) 469-7696
NPI assigned
Mar 1, 2012
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
021002604ILMDPediatric Dentist
DS040633PAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kyla Dental LTD Current
since Nov 21, 2021		 Accepting new patients

Locations

493 Duane St
Ste 201
Glen Ellyn, IL 60137

722 S President St
Wheaton, IL 60189
Phone (630) 469-7696

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DS040633 PA
Pediatric Dentistry 1223P0221X 021002604 IL Yes

Addresses

Primary practice location

722 S President St
Wheaton, IL 60189

Mailing address

722 S President St
Wheaton, IL 60189-6606
Phone (630) 469-7696

Other practice location 1

1203 E Main St
St Charles, IL 60174
Phone (630) 883-0856

Other names

  • Dr. Kajal Bhavesh Patel Former name

Other providers in Wheaton, IL

All providers in Wheaton, IL · Pediatric Dentistry in Illinois

Sources for this page

Verify at the official NPI Registry.