Individual provider Active NPI

Amee Pathak, D.M.D.

  • Dentist
  • Carrollton, TX
National Provider Identifier
1518270891
Registry record updated Feb 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
25967 Issued in TX
Practice address
2604 Old Denton Rd
Carrollton, TX 75007-5109
Phone
(213) 344-8609
NPI assigned
Jul 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 25967 TX Primary

Addresses

Primary practice location

2604 Old Denton Rd
Carrollton, TX 75007-5109

Mailing address

1001 Lake Carolyn Pkwy Apt 452
Irving, TX 75039-4814
Phone (213) 344-8609

Other identifiers 2

IdentifierTypeStateIssuer
2010020531MedicaidMO
2010020531OtherMOPEDIACTRICS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160421002509 TX Order and Referring Only - DentistPractitioner - Dentist 3375842594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518825600000",
    "number": "1518270891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 LAKE CAROLYN PKWY APT 452",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750394814",
            "telephone_number": "213-344-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 OLD DENTON RD",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750075109",
            "telephone_number": "213-344-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHAK",
        "first_name": "AMEE",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2018-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "25967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010020531",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIACTRICS",
            "identifier": "2010020531",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

Verify at the official NPI Registry.