Individual provider Active NPI

Shreeja Patel

  • General Practice Dentistry
  • Amarillo, TX
National Provider Identifier
1902583008
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39778 Issued in TX
Practice address
3630 SW 45TH Ave
Amarillo, TX 79109-5689
Phone
(806) 223-2886
NPI assigned
Jun 29, 2023
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 39778 TX Primary

Addresses

Primary practice location

3630 SW 45TH Ave
Amarillo, TX 79109-5689

Mailing address

3630 SW 45TH Ave
Amarillo, TX 79109-5689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231002001412 TX Order and Referring Only - DentistPractitioner - Dentist 4688028194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39778TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Abbeville Dentistry - Amarillo, PLLC PastSince Jul 2, 2023 Accepting new patients
Abbeville Dentistry - Amarillo, PLLC General Practice PastSince Jul 2, 2023 Accepting new patients

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": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1902583008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 SW 45TH AVE",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791095689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 SW 45TH AVE",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791095689",
            "telephone_number": "806-223-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHREEJA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "39778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.