Individual provider Active NPI

Komal Patel, D.M.D

  • Dentist
  • Township of Washington, NJ
National Provider Identifier
1932332863
Registry record updated Aug 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02414000 Issued in NJ
Practice address
11 Viola Ter
Township of Washington, NJ 07676-4754
Phone
(646) 321-9140
NPI assigned
Aug 26, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02414000 NJ Primary

Addresses

Primary practice location

11 Viola Ter
Township of Washington, NJ 07676-4754

Mailing address

11 Viola Ter
Township of Washington, NJ 07676-4754
Phone (646) 321-9140

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
I20170106000581 TX Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2365723376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02414000NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251244800000",
    "number": "1932332863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 VIOLA TER",
            "city": "TOWNSHIP OF WASHINGTON",
            "state": "NJ",
            "postal_code": "076764754",
            "telephone_number": "646-321-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 VIOLA TER",
            "city": "TOWNSHIP OF WASHINGTON",
            "state": "NJ",
            "postal_code": "076764754",
            "telephone_number": "646-321-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KOMAL",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2009-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02414000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Township of Washington, NJ

Sources for this page

Verify at the official NPI Registry.