Amish Jayendra Patel, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN122207 Issued in GA

Practice address

145 Medical Blvd
Stockbridge, GA 30281-5083

Phone

(770) 389-0389

NPI assigned

Sep 12, 2014

Last updated

Feb 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

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.

• Amish Patel DMD LLC

  • Dental Clinic/Center
  • Stockbridge, GA
  • NPI 1376277079
  NPD Authorized official
• Virginia M. Melmed, D.D.S., P.a.

  • General Practice Dentistry
  • Clearwater, FL
  • NPI 1124728753
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1679974224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 CARRIAGE LAKE DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MEDICAL BLVD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815083",
            "telephone_number": "770-389-0389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38 Carriage Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302816275",
            "country_code": "US",
            "telephone_number": "404-579-0740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AMISH",
        "middle_name": "JAYENDRA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-12",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122207",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 20894",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josefina Padiernos Parungao, MD
• Cecile Julienne Pasion-Bregman, M.D.
• Romona Marie Paster
• Joseph T Pate Jr., PHD
• Aayush Gautam Patel, DO
• Bhavinkumar Popatlal Patel, MD
• Chirag R Patel, M.D.
• Darshan Ashokkumar Patel
• Hetal Patel
• Jignesh Patel

• General Practice Dentistry in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.