Active NPI
Bonnie Priti Patel, D.D.S.
- Dentist
- Ann Arbor, MI
National Provider Identifier
1497883284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16497
- Practice address
- 1795 W Stadium Blvd
Ann Arbor, MI 48103-5290 - Phone
- (734) 761-2144
- Fax
- (734) 662-4156
- NPI assigned
- Mar 1, 2007
- 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 | 16497 | MI | Primary |
Addresses
Primary practice location
1795 W Stadium Blvd
Ann Arbor, MI 48103-5290
Mailing address
1795 W Stadium Blvd
Ann Arbor, MI 48103-5290
Phone (734) 761-2144
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 |
|---|---|---|---|
| 16497 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kristin F. Nickodemus, DDS, PLC | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Ann Arbor, MI
- NPI 1215481155
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497883284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1795 W STADIUM BLVD",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481035290",
"telephone_number": "734-761-2144",
"fax_number": "734-662-4156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1795 W STADIUM BLVD",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481035290",
"telephone_number": "734-761-2144",
"fax_number": "734-662-4156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "BONNIE",
"middle_name": "PRITI",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "16497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.