Individual provider Active NPI

Vidhi Rakeshkumar Patel

  • Dentist
  • Greenwood, IN
National Provider Identifier
1689308538
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12013879A Issued in IN
Practice address
2826 S State Road 135 Ste C
Greenwood, IN 46143-9603
Phone
(317) 743-7777
NPI assigned
Jul 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12013879A IN Primary

Addresses

Primary practice location

2826 S State Road 135 Ste C
Greenwood, IN 46143-9603

Mailing address

15103 Bentfield CT
Fishers, IN 46037-5534

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
12013879AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Olive Branch Dental LLC CurrentSince Jul 17, 2022 Accepting new patients

Locations

2826 S State Road 135
Ste C
Greenwood, IN 46143
Phone (260) 750-0418

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": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1689308538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15103 BENTFIELD CT",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460375534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2826 S STATE ROAD 135 STE C",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461439603",
            "telephone_number": "317-743-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "VIDHI",
        "middle_name": "RAKESHKUMAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013879A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.