Individual provider Active NPI

Ishaan Patel, DDS

  • Dentist
  • Taylor, MI
National Provider Identifier
1609420850
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901600251 Issued in MI
Practice address
9115 Telegraph Rd
Taylor, MI 48180-2365
Phone
(313) 908-1788
NPI assigned
Jul 26, 2019
Last updated
Jul 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901600251 MI Primary

Addresses

Primary practice location

9115 Telegraph Rd
Taylor, MI 48180-2365

Mailing address

41 Glenhaven St.
Markham, ONTARIO L6C 2W8
CA

Other practice location 1

16201 Ford Rd
Dearborn, MI 48126-2945
Phone (313) 451-8304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190819000084 MI Order and Referring Only - DentistPractitioner - Dentist 4880922608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901600251MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Dental Mi 1 PC CurrentSince Sep 23, 2024 Accepting new patients
D2 Dental of Michigan, P.C. PastSince Jul 28, 2019 Accepting new patients

Locations

9115 Telegraph Rd
Taylor, MI 48180
Phone (313) 908-1788

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": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1609420850",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "41 GLENHAVEN ST.",
            "city": "MARKHAM",
            "state": "ONTARIO",
            "postal_code": "L6C 2W8"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9115 TELEGRAPH RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481802365",
            "telephone_number": "313-908-1788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16201 Ford Rd",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481262945",
            "country_code": "US",
            "telephone_number": "313-451-8304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ISHAAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

Verify at the official NPI Registry.