Individual provider Active NPI

Rina Patel, D.M.D.

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1689002289
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
62657 Issued in CA
Practice address
5638 Mission Center Rd
Suite 107
San Diego, CA 92108-4348
Phone
(619) 220-0159
NPI assigned
Oct 17, 2013
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 29457 TX
General Practice Dentistry 1223G0001X 62657 CA Primary

Addresses

Primary practice location

5638 Mission Center Rd
Suite 107
San Diego, CA 92108-4348

Mailing address

1601 Precision Park LN Ste 107
San Diego, CA 92173-1345
Phone (619) 936-3823

Other practice location 1

330 E 8th St
National City, CA 91950-2312
Phone (619) 662-4100

Other identifiers 1

IdentifierTypeStateIssuer
324581301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250312002040 CA Practitioner - Dentist 4385951847 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29457TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc CurrentSince Mar 3, 2025 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Mar 3, 2025 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Past Accepting new patients
Lance Rygg Professional Dental Corporation General Practice Past Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

Organizations & group practices 5

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": "1381968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1689002289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 PRECISION PARK LN STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921731345",
            "telephone_number": "619-936-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5638 MISSION CENTER RD",
            "address_2": "SUITE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084348",
            "telephone_number": "619-220-0159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 E 8th St",
            "address_purpose": "LOCATION",
            "city": "National City",
            "state": "CA",
            "postal_code": "919502312",
            "country_code": "US",
            "telephone_number": "619-662-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RINA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-17",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29457",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324581301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.