Individual provider Active NPI

Kishori Dinesh Patel, DDS

  • Dentist
  • Woodbridge, VA
National Provider Identifier
1912893249
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401419693 Issued in VA
Practice address
16689 River Ridge Blvd
Woodbridge, VA 22191-4630
Phone
(703) 221-9759
NPI assigned
Jun 13, 2025
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

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
0401419693VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Adam Dental Care Past Accepting new patients
Team Dental at River Oaks Past Accepting new patients
Family Dentistry of Melwood LLC PastSince Jun 1, 2025 Accepting new patients
Fairfax Modern Dentistry, PC Dentist PastSince Aug 25, 2025 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401419693 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

16689 River Ridge Blvd
Woodbridge, VA 22191-4630

Mailing address

16689 River Ridge Blvd
Woodbridge, VA 22191-4630
Phone (703) 221-9759

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 7, 2026.

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1912893249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16689 RIVER RIDGE BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914630",
            "telephone_number": "703-221-9759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16689 RIVER RIDGE BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914630",
            "telephone_number": "703-221-9759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KISHORI",
        "middle_name": "DINESH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-13",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401419693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; 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.