Individual provider Active NPI

Lavenderjit K Mehat, DDS

  • General Practice Dentistry
  • Wake Forest, NC
National Provider Identifier
1649970088
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13640 Issued in NC
Practice address
941 Gateway Commons Cir Ste 109
Wake Forest, NC 27587-6604
Phone
(919) 694-3148
NPI assigned
Mar 6, 2023
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TX
General Practice Dentistry 1223G0001X 13640 NC Primary

Addresses

Primary practice location

941 Gateway Commons Cir Ste 109
Wake Forest, NC 27587-6604

Mailing address

10 Fenton Main St Apt 459
Cary, NC 27511-7801
Phone (210) 784-7750

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

LicenseStateTypeSpecialty
13640NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Marisa Napoli DMD PLLC PastSince Aug 18, 2024 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, 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": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1649970088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FENTON MAIN ST APT 459",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275117801",
            "telephone_number": "210-784-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 GATEWAY COMMONS CIR STE 109",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876604",
            "telephone_number": "919-694-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHAT",
        "first_name": "LAVENDERJIT",
        "middle_name": "K",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.