Individual provider Active NPI

Dhaval Patel, DMD

  • Dentist
  • Normal, IL
National Provider Identifier
1750766499
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.030334 Issued in IL
Practice address
1604 Visa Dr
Normal, IL 61761-2195
Phone
(309) 585-2522
NPI assigned
Jul 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.030334 IL Primary

Addresses

Primary practice location

1604 Visa Dr
Normal, IL 61761-2195

Mailing address

110 W Center St # NA
Ottawa, IL 61350-3557
Phone (815) 434-6411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20250102000888 IL Practitioner - Dentist 0749722080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Midwestern University College of Dental Medicine, Downers Grove, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Sleep Better IncGroup PAC ID 8123560463, 2 clinicians

Practice addresses (Care Compare)

4260 Westbrook Dr
Suite 105
Aurora, IL 60504-8136
Phone (630) 566-7737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.030334ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Better Inc Dentist CurrentSince Oct 6, 2024 Accepting new patients
Sleep Better Inc General Practice CurrentSince Nov 27, 2023 Accepting new patients

Locations

4260 Westbrook Dr
Ste 105
Aurora, IL 60504
Phone (630) 566-7737

110 W Center St
Ottawa, IL 61350
Phone (630) 566-7737

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1750766499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W CENTER ST # NA",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613503557",
            "telephone_number": "815-434-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 VISA DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612195",
            "telephone_number": "309-585-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DHAVAL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-23",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.030334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.