Individual provider Active NPI

Dhruvina Patel

  • Dentist
  • Louisville, KY
National Provider Identifier
1770075202
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10095 Issued in KY
Practice address
4740 Dixie Hwy
Louisville, KY 40216-2656
Phone
(502) 447-8992
NPI assigned
May 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10095 KY Primary

Addresses

Primary practice location

4740 Dixie Hwy
Louisville, KY 40216-2656

Mailing address

4740 Dixie Hwy
Louisville, KY 40216-2656
Phone (502) 447-8992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20180718002693 KY Order and Referring Only - DentistPractitioner - Dentist 8022365386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10095KYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mortenson Family Dental Center - Dixie at Rockford Lane, PLLC Dentist PastSince Aug 11, 2019 Accepting new patients

Organizations & group practices 1

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": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1770075202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402162656",
            "telephone_number": "502-447-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402162656",
            "telephone_number": "502-447-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DHRUVINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.