Individual provider Active NPI

Deepa Patel, DDS

  • Pediatric Dentistry
  • Charlotte, NC
National Provider Identifier
1770612558
Registry record updated Oct 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
11491 Issued in NC
Practice address
1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228
Phone
(803) 149-6900
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 11491 NC Primary

Addresses

Primary practice location

1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228

Mailing address

1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228
Phone (704) 336-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11491NCMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696636800000",
    "number": "1770612558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 ROZZELLES FERRY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282084228",
            "telephone_number": "704-336-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 ROZZELLES FERRY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282084228",
            "telephone_number": "803-149-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DEEPA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2023-10-07",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "11491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.