Active NPI
Alyssa Patel
- General Practice Dentistry
- Marietta, GA
National Provider Identifier
1558095398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN122780
- Practice address
- 2655 Dallas Hwy SW Ste 510
Marietta, GA 30064-7520 - Phone
- (770) 422-8776
- NPI assigned
- Jul 15, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN122780 | GA | Primary |
Addresses
Primary practice location
2655 Dallas Hwy SW Ste 510
Marietta, GA 30064-7520
Mailing address
1105 Columbus Pkwy
Opelika, AL 36804-5943
Phone (334) 421-1883
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 |
|---|---|---|---|
| DN122780 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660003200000",
"number": "1558095398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 COLUMBUS PKWY",
"city": "OPELIKA",
"state": "AL",
"postal_code": "368045943",
"telephone_number": "334-421-1883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2655 DALLAS HWY SW STE 510",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300647520",
"telephone_number": "770-422-8776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "ALYSSA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-15",
"last_updated": "2022-08-09",
"certification_date": "2022-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN122780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.