Active NPI
Pruthul Patel, DMD
- Dentist
- Jacksonville, FL
National Provider Identifier
1508435785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN26093
- Practice address
- 8440 Blanding Blvd
Jacksonville, FL 32244-5725 - Phone
- (718) 908-3536
- NPI assigned
- Jun 22, 2021
- Sex
- Male
- 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 | DN26093 | FL | Primary |
Addresses
Primary practice location
8440 Blanding Blvd
Jacksonville, FL 32244-5725
Mailing address
1710 Wells Rd Apt 1012
Orange Park, FL 32073-2349
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 |
|---|---|---|---|
| DN26093 | FL | MD | Dentist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1508435785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1710 WELLS RD APT 1012",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320732349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8440 BLANDING BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322445725",
"telephone_number": "718-908-3536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "PRUTHUL",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-22",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN26093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.