NPIMap

Organization Active NPI

FCD of Jackson, PLLC

  • General Practice Dentistry
  • Jackson, TN
National Provider Identifier
1568538965
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FCD OF JACKSON, PLLC
Practice address
1523 S. Highland Avenue
Jackson, TN 38301-7520
Phone
(731) 424-6452
Fax
(731) 424-9719
NPI assigned
Nov 28, 2006
Last updated
Jan 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Authorized official

Name
Minish Y. Patel, DR.
Title
Doctor/Owner
Phone
(731) 424-6452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

1523 S. Highland Avenue
Jackson, TN 38301-7520

Mailing address

1523 S. Highland Avenue
Jackson, TN 38301-7520
Phone (731) 424-6452

Other identifiers 1

IdentifierTypeStateIssuer
1526237MedicaidTN

Other names 1

  • Minesh Y. Patel, DDS dba Family &Cosmetic Dentistry of Jackson Former legal business name

National Provider Directory

National Provider Directory

Locations

1523 S Highland Ave
Jackson, TN 38301
Phone (731) 424-6452

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1568538965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 S. HIGHLAND AVENUE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383017520",
            "telephone_number": "731-424-6452",
            "fax_number": "731-424-9719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 S. HIGHLAND AVENUE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383017520",
            "telephone_number": "731-424-6452",
            "fax_number": "731-424-9719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FCD OF JACKSON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MINISH",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "731-424-6452",
        "authorized_official_credential": "DR."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1526237",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minesh Y. Patel, DDS dba Family &Cosmetic Dentistry of Jackson",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.