Individual provider Active NPI

Nutan K Patel, DDS

  • General Practice Dentistry
  • Perth Amboy, NJ
National Provider Identifier
1528556537
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI01845300 Issued in NJ
Practice address
505 New Brunswick Ave
Perth Amboy, NJ 08861-3653
Phone
(732) 826-8464
Fax
(732) 826-4022
NPI assigned
Apr 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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 22DI01845300 NJ Primary

Addresses

Primary practice location

505 New Brunswick Ave
Perth Amboy, NJ 08861-3653

Mailing address

505 New Brunswick Ave
Perth Amboy, NJ 08861-3653
Phone (732) 826-8464

Other identifiers 1

IdentifierTypeStateIssuer
3300102MedicaidNJ

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
22DI01845300NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Maureen Fraser,D.D.S.,LLC General Practice 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, 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": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1528556537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613653",
            "telephone_number": "732-826-8464",
            "fax_number": "732-826-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613653",
            "telephone_number": "732-826-8464",
            "fax_number": "732-826-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NUTAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01845300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3300102",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.