Individual provider Active NPI

Indravadan Dahyabhai Patel, D.D.S.

  • Dentist
  • Anaheim, CA
National Provider Identifier
1659526366
Registry record updated Feb 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D35153 Issued in CA
Practice address
1018 E Sycamore St
Anaheim, CA 92805-2165
Phone
(714) 520-4541
Fax
(714) 520-4543
NPI assigned
Nov 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDO35153 CA
Dentist 122300000X D35153 CA Primary

Addresses

Primary practice location

1018 E Sycamore St
Anaheim, CA 92805-2165

Mailing address

1018 E Sycamore St
Suite 103
Anaheim, CA 92805-2165
Phone (714) 520-4541

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
D35153CAMDDentist
DDO35153CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Indravadan D Patel DDS Inc 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": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549065600000",
    "number": "1659526366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 E SYCAMORE ST",
            "address_2": "SUITE 103",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928052165",
            "telephone_number": "714-520-4541",
            "fax_number": "714-520-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 E SYCAMORE ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928052165",
            "telephone_number": "714-520-4541",
            "fax_number": "714-520-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "INDRAVADAN",
        "middle_name": "DAHYABHAI",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-21",
        "last_updated": "2019-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDO35153",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "D35153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2019; 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.