Active NPI
Shruti J Patel, DDS
- General Practice Dentistry
- Columbia, SC
National Provider Identifier
1639328859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8065
- Practice address
- 101 Wildewood Park Dr
Suite a
Columbia, SC 29223-4319 - Phone
- (803) 393-4600
- NPI assigned
- Sep 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8065 | SC | Primary |
Addresses
Primary practice location
101 Wildewood Park Dr
Suite a
Columbia, SC 29223-4319
Mailing address
101 Wildewood Park Dr
Suite a
Columbia, SC 29223-4319
Phone (803) 393-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8065 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Smile Studio Family Dentistry | 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.
-
- Dental Clinic/Center
- Columbia, SC
- NPI 1659775070
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407196800000",
"number": "1639328859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 WILDEWOOD PARK DR",
"address_2": "SUITE A",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292234319",
"telephone_number": "803-393-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WILDEWOOD PARK DR",
"address_2": "SUITE A",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292234319",
"telephone_number": "803-393-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "SHRUTI",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-11",
"last_updated": "2014-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "8065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.