Individual provider Active NPI

Vikaskumar Patel

  • Dentist
  • Olney, MD
National Provider Identifier
1528475274
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
15616 Issued in MD
Practice address
18121 Georgia Ave Ste 110
Olney, MD 20832-1437
Phone
(240) 390-0290
NPI assigned
Jul 15, 2014
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15616 MD Primary

Addresses

Primary practice location

18121 Georgia Ave Ste 110
Olney, MD 20832-1437

Mailing address

18121 Georgia Ave Ste 110
Olney, MD 20832-1437
Phone (240) 390-0290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20150610001506 MD Order and Referring Only - DentistPractitioner - Dentist 7810218260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15616MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Smiles in Olney LLC CurrentSince Jun 18, 2023 Accepting new patients
Dental Professionals of Maryland, Badger, P.C. Past Accepting new patients

Locations

18121 Georgia Ave
Ste 110
Olney, MD 20832
Phone (240) 390-0276

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1528475274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18121 GEORGIA AVE STE 110",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321437",
            "telephone_number": "240-390-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18121 GEORGIA AVE STE 110",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321437",
            "telephone_number": "240-390-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "VIKASKUMAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-15",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.