Individual provider Active NPI

Samip Patel

  • General Practice Dentistry
  • Tucson, AZ
National Provider Identifier
1811427073
Registry record updated Jun 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D009777 Issued in AZ
Practice address
8160 S Houghton Rd Ste 130
Tucson, AZ 85747-9720
Phone
(520) 901-8095
NPI assigned
Jun 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D009777 AZ Primary

Addresses

Primary practice location

8160 S Houghton Rd Ste 130
Tucson, AZ 85747-9720

Mailing address

8160 S Houghton Rd Ste 130
Tucson, AZ 85747-9720
Phone (520) 663-4089

Other identifiers 1

IdentifierTypeStateIssuer
W235616293OtherMO(80840) 9140860054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170814002777 CA Order and Referring Only - DentistPractitioner - Dentist 3274805098

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D009777AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rita Ranch Dental Group, LLP General Practice Past 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, 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": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1811427073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8160 S HOUGHTON RD STE 130",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857479720",
            "telephone_number": "520-663-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8160 S HOUGHTON RD STE 130",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857479720",
            "telephone_number": "520-901-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SAMIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-19",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "(80840) 9140860054",
            "identifier": "W235616293",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.