Komal S Patel, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901021723 Issued in MI

Practice address

28345 Beck Rd
#409
Wixom, MI 48393-4733

Phone

(888) 477-7325

NPI assigned

Jul 1, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: komal.patel.1@25862.direct.athenahealth.com

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.

• Hamilton Community Health Network Inc.

  • Federally Qualified Health Center (FQHC)
  • Flint, MI
  • NPI 1386624278
  Medicare reassignment NPD
• Hamilton Community Health Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Burton, MI
  • NPI 1639997257
  NPD

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1902117203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2281 LAKE RIDGE DR",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397365",
            "telephone_number": "919-306-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28345 BECK RD",
            "address_2": "#409",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483934733",
            "telephone_number": "888-477-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KOMAL",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021723",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "055639",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI02502600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orr Enterprise Dba Caring Matters Home Care 013
• Greta Osho
• Bradley William Page, PT
• Lorelei Papke, RN
• Papnez PLLC
• Sheel Vipul Patel, FNP-BC
• Amanda K Peters
• Barbara Jane Petroff, RPH
• Phree Space Inc
• Pillpack LLC

• Dentist in Wixom, MI
• Providers in Wixom, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.