Mitava Prajay Patel, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401418502 Issued in VA

Practice address

4124 River Park Dr
Suffolk, VA 23435-3357

Phone

(717) 856-3460

NPI assigned

Jun 14, 2023

Last updated

Jun 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1700560042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4124 RIVER PARK DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353357",
            "telephone_number": "717-856-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4124 RIVER PARK DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353357",
            "telephone_number": "717-856-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MITAVA",
        "middle_name": "PRAJAY",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bhavita Patel, APN
• Bhrantiben Patel
• Dhaval H Patel
• Jeesha Patel, DPM
• Keya J Patel, PT, DPT
• Saurabhkumar Patel, M.D
• Vania Ciric Patel, MS CCC-SLP
• Pathways to Life, Inc.
• Jeremy Patterson
• Maya Patterson

• General Practice Dentistry in Suffolk, VA
• Providers in Suffolk, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.