Individual provider Active NPI

Carol A. Patel, DMD

  • General Practice Dentistry
  • Augusta, GA
National Provider Identifier
1730633959
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN015260 Issued in GA
Practice address
1631 Gordon Hwy Ste 22
Augusta, GA 30906-2230
Phone
(706) 790-9302
Fax
(706) 790-9303
NPI assigned
Aug 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN015260 GA Primary

Addresses

Primary practice location

1631 Gordon Hwy Ste 22
Augusta, GA 30906-2230

Mailing address

1631 Gordon Hwy Ste 22
Augusta, GA 30906-2230
Phone (706) 790-9302

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
DN015260GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta Smiles Youth Dentistry, PC General Practice Past Accepting new patients
Bridgeport River Dental PC General Practice PastSince Sep 8, 2019 Accepting new patients

Organizations & group practices 2

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": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1730633959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 GORDON HWY STE 22",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062230",
            "telephone_number": "706-790-9302",
            "fax_number": "706-790-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 GORDON HWY STE 22",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062230",
            "telephone_number": "706-790-9302",
            "fax_number": "706-790-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "CAROL",
        "middle_name": "A.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; 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.