Derek Henry Patao, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

105389 Issued in CA

Practice address

932 N Brand Blvd Ste a
Glendale, CA 91202-2905

Phone

(818) 843-4322

NPI assigned

Aug 28, 2020

Last updated

May 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Patao Dental Corporation

  dba Derek Patao DDS

  • Dental Clinic/Center
  • Glendale, CA
  • NPI 1679233407
  NPD Authorized official

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1730792797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 N BRAND BLVD STE A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022905",
            "telephone_number": "818-843-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 N BRAND BLVD STE A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022905",
            "telephone_number": "818-843-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATAO",
        "first_name": "DEREK",
        "middle_name": "HENRY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105389",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105389",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Glendale",
            "affiliation": "N",
            "address_1": "932 N Brand Blvd Ste A",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912022905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Parvaneh Rafaeloff, MD, Inc.
• Edmund O Pascual, MD
• Noune Pashinian, MD
• Rommel Lato Pastor, RDA
• Patao Dental Corporation (Derek Patao DDS)
• Ami N Patel, M.D.
• Neha Patel
• Priya P Patel, PA-C
• Rupeshbhai A. Patel, D.C.
• Sameer A Patel, M.D.

• Dentist in Glendale, CA
• Providers in Glendale, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.