Ajit A Patel, D.D.S., M.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

0401410850 Issued in VA

Practice address

42882 Truro Parish Dr
Suite 205
Broadlands, VA 20148-4456

Phone

(703) 726-4333

Fax

(703) 726-4334

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699844266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42882 TRURO PARISH DR",
            "address_2": "SUITE 205",
            "city": "BROADLANDS",
            "state": "VA",
            "postal_code": "201484456",
            "telephone_number": "703-726-4333",
            "fax_number": "703-726-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42882 TRURO PARISH DR",
            "address_2": "SUITE 205",
            "city": "BROADLANDS",
            "state": "VA",
            "postal_code": "201484456",
            "telephone_number": "703-726-4333",
            "fax_number": "703-726-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AJIT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401410850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109269",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL HEALTH ALLIANCE",
            "identifier": "75316",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1650920",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "176194",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Optimeyes LLC
• Laurie Ottehenning
• Kathryn W Palmer, PT, DPT
• Harveen Pantleay
• John Sir Park
• Maunika Patel
• Pearl Home Care LLC
• Rileigh Perkins, M.S. CF-SLP
• Rachel Peterson
• Luke Charles Pietrantone, DC

• Pediatric Dentistry in Broadlands, VA
• Providers in Broadlands, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.