Individual provider Active NPI

Jay Vijendra Patel, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lawrenceville, GA
National Provider Identifier
1528298080
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN013923 Issued in GA
Practice address
2087 Cruse Rd Ste B
Lawrenceville, GA 30044-2345
Phone
(770) 521-2100
NPI assigned
Jul 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN013923 GA Primary

Addresses

Primary practice location

2087 Cruse Rd Ste B
Lawrenceville, GA 30044-2345

Mailing address

2087 Cruse Rd Ste B
Lawrenceville, GA 30044-2345
Phone (770) 521-2100

Other practice location 1

13075 Highway 9 N Ste 110
Milton, GA 30004-5147
Phone (770) 521-2100

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

LicenseStateTypeSpecialty
DN013923GAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Gocd Lawrenceville LLC General Practice CurrentSince Oct 12, 2025 Accepting new patients
JPC Dental Group Orthodontics and Dentofacial Orthopedics Past Accepting new patients
Georgia Dental Professionals, PC General Practice Past Accepting new patients

Locations

2087 Cruse Rd
#B
Lawrenceville, GA 30044
Phone (770) 521-2100

Organizations & group practices 3

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": "1247961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1528298080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2087 CRUSE RD STE B",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300442345",
            "telephone_number": "770-521-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2087 CRUSE RD STE B",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300442345",
            "telephone_number": "770-521-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13075 Highway 9 N Ste 110",
            "address_purpose": "LOCATION",
            "city": "Milton",
            "state": "GA",
            "postal_code": "300045147",
            "country_code": "US",
            "telephone_number": "770-521-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JAY",
        "middle_name": "VIJENDRA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-19",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN013923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.