Jonathan Robert Patrick, D.D.S., M.S

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30790 Issued in TX

Practice address

24510 Eastex Fwy Ste 110
Kingwood, TX 77339-2698

Phone

(281) 608-7535

Fax

(281) 608-7537

NPI assigned

Mar 14, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Care for Kids Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Kingwood, TX
  • NPI 1548713688
  NPD (past) Authorized official

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541808000000",
    "number": "1619218799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24510 HIGHWAY 59 N STE 110",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392692",
            "telephone_number": "281-608-7535",
            "fax_number": "281-608-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24510 EASTEX FWY STE 110",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392698",
            "telephone_number": "281-608-7535",
            "fax_number": "281-608-7537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "JONATHAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-14",
        "last_updated": "2018-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "30790",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "30790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "357948401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "357948402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raj Patel, MD
• Rupa Patel, M.D.
• Sanjay Patel
• Path to Serenity Counseling, PLLC
• Shreena Patidar
• Allison Paul
• Kathleen Lynn Paul, LPC
• Meghan Payne, SLP
• Pearl Cosmetic Dentistry, PLLC
• Jasmine Pearson, MA.,LPC, LCDC

• Pediatric Dentistry in Kingwood, TX
• Providers in Kingwood, TX by specialty
• Pediatric Dentistry in Texas

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