Active NPI
Tarun Ballubhai Patel, DDS
- Dentist
- Pacoima, CA
National Provider Identifier
1679728943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 53641
- Practice address
- 13279 Van Nuys Blvd
Pacoima, CA 91331-3003 - Phone
- (818) 899-2505
- NPI assigned
- Nov 29, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 53641 | CA | Primary |
Addresses
Primary practice location
13279 Van Nuys Blvd
Pacoima, CA 91331-3003
Mailing address
17716 Tulsa St
Granada Hills, CA 91344-4528
Phone (818) 675-3330
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 |
|---|---|---|---|
| 53641 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239148800000",
"number": "1679728943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17716 TULSA ST",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "913444528",
"telephone_number": "818-675-3330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13279 VAN NUYS BLVD",
"city": "PACOIMA",
"state": "CA",
"postal_code": "913313003",
"telephone_number": "818-899-2505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "TARUN",
"middle_name": "BALLUBHAI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-29",
"last_updated": "2009-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "53641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pacoima, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.