Individual provider Active NPI

Dhruva Patel, DMD

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1730665852
Registry record updated Oct 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN015717 Issued in GA
Practice address
4805 Briarcliff Rd NE Ste 104
Atlanta, GA 30345-2737
Phone
(404) 315-7375
NPI assigned
Jul 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2019

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 DN015717 GA Primary

Addresses

Primary practice location

4805 Briarcliff Rd NE Ste 104
Atlanta, GA 30345-2737

Mailing address

4660 Parkview Walk Dr
Lilburn, GA 30047-8971
Phone (404) 435-8989

Other practice location 1

4660 Parkview Walk Dr
Lilburn, GA 30047-8971
Phone (404) 435-8989

Other identifiers 1

IdentifierTypeStateIssuer
DN015717MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20181108002446 GA Order and Referring Only - DentistPractitioner - Other (Physician)Practitioner - Dentist 4880948942

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN015717GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570233600000",
    "number": "1730665852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 PARKVIEW WALK DR",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300478971",
            "telephone_number": "404-435-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 BRIARCLIFF RD NE STE 104",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452737",
            "telephone_number": "404-315-7375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4660 Parkview Walk Dr",
            "address_purpose": "LOCATION",
            "city": "Lilburn",
            "state": "GA",
            "postal_code": "300478971",
            "country_code": "US",
            "telephone_number": "404-435-8989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DHRUVA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2019-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DN015717",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.