Individual provider Active NPI

Kinnery Ajit Patel, D.D.S.

  • Dentist
  • Chicago, IL
National Provider Identifier
1659686384
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.028460 Issued in IL
Practice address
3800 N Pulaski Rd
Chicago, IL 60641-3197
Phone
(773) 663-6800
NPI assigned
Aug 18, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.028460 IL Primary

Addresses

Primary practice location

3800 N Pulaski Rd
Chicago, IL 60641-3197

Mailing address

359 N Adele St
Elmhurst, IL 60126-2409
Phone (248) 497-6850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150622001405 IL Order and Referring Only - DentistPractitioner - Dentist 3072824721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.028460ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kinnery Patel, DDS, LTD. Dentist CurrentSince Dec 28, 2025 Accepting new patients

Locations

3800 N Pulaski Rd
Chicago, IL 60641
Phone (773) 663-3800

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": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1659686384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 N ADELE ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262409",
            "telephone_number": "248-497-6850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606413197",
            "telephone_number": "773-663-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KINNERY",
        "middle_name": "AJIT",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-18",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.028460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.