Individual provider Active NPI

Kinjal Mukeh Patel, D.D.S.

  • General Practice Dentistry
  • Fairfax, VA
National Provider Identifier
1497987366
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401412506 Issued in VA
Practice address
10801 Main St
Suite 500 and 600
Fairfax, VA 22030-4727
Phone
(703) 532-2500
NPI assigned
Aug 11, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401412506 VA Primary

Addresses

Primary practice location

10801 Main St
Suite 500 and 600
Fairfax, VA 22030-4727

Mailing address

10801 Main St
Apt 5401
Fairfax, VA 22030-4727
Phone (703) 352-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160404001052 VA Order and Referring Only - DentistPractitioner - Dentist 2668779869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401412506VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John S K Hsu DDS and Virginia G Chin DDS PC 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.

NPI Registry JSON

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1497987366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10801 MAIN ST",
            "address_2": "APT 5401",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304727",
            "telephone_number": "703-352-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 MAIN ST",
            "address_2": "SUITE 500 AND 600",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304727",
            "telephone_number": "703-532-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KINJAL",
        "middle_name": "MUKEH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-11",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.