Active NPI
Ishaan Patel, DDS
- Dentist
- Taylor, MI
National Provider Identifier
1609420850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901600251
- Practice address
- 9115 Telegraph Rd
Taylor, MI 48180-2365 - Phone
- (313) 908-1788
- NPI assigned
- Jul 26, 2019
- Last updated
- Jul 26, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190819000084 | MI | Order and Referring Only - Dentist | 4880922608 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901600251 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pro Dental Mi 1 PC | Current | Accepting new patients | |
| D2 Dental of Michigan, P.C. | Past | 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.
-
dba Destiny Dental of Taylor
- General Practice Dentistry
- Taylor, MI
- NPI 1780411058
-
- General Practice Dentistry
- Taylor, MI
- NPI 1588136667
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.