Individual provider Active NPI

Mitul R Patel, D.D.S.

  • General Practice Dentistry
  • Suwanee, GA
National Provider Identifier
1639283229
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013153 Issued in GA
Practice address
2627 Peachtree Pkwy
Suite 440
Suwanee, GA 30024-1018
Phone
(770) 888-3384
Fax
(770) 888-3081
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN013153 GA Primary

Addresses

Primary practice location

2627 Peachtree Pkwy
Suite 440
Suwanee, GA 30024-1018

Mailing address

2627 Peachtree Pkwy
Suite 440
Suwanee, GA 30024-1018
Phone (770) 888-3384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150702001322 GA Order and Referring Only - Other (Non-Physician) 9335451467

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
M & T Synergy, PC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639283229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 PEACHTREE PKWY",
            "address_2": "SUITE 440",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241018",
            "telephone_number": "770-888-3384",
            "fax_number": "770-888-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 PEACHTREE PKWY",
            "address_2": "SUITE 440",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241018",
            "telephone_number": "770-888-3384",
            "fax_number": "770-888-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MITUL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.