Individual provider Active NPI

Amit Patel

  • General Practice Dentistry
  • Madison Heights, VA
National Provider Identifier
1750010757
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401418707 Issued in VA
Practice address
109 Clearview Rd
Madison Heights, VA 24572-2600
Phone
(434) 455-2480
NPI assigned
Jun 7, 2022
Last updated
Jul 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401418707 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

109 Clearview Rd
Madison Heights, VA 24572-2600

Mailing address

134 Elon Rd
Madison Heights, VA 24572-2536
Phone (434) 455-2480

Other practice location 1

1600 Medical Center Dr
Huntington, WV 25701-3656
Phone (304) 691-1824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20241218004157 VA Order and Referring Only - DentistPractitioner - Dentist 7416484191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401418707VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1750010757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 ELON RD",
            "city": "MADISON HEIGHTS",
            "state": "VA",
            "postal_code": "245722536",
            "telephone_number": "434-455-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CLEARVIEW RD",
            "city": "MADISON HEIGHTS",
            "state": "VA",
            "postal_code": "245722600",
            "telephone_number": "434-455-2480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257013656",
            "country_code": "US",
            "telephone_number": "304-691-1824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AMIT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-07",
        "last_updated": "2024-07-05",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418707",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison Heights, VA

Sources for this page

Verify at the official NPI Registry.