Krupa Patel Bordatto, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019.029869 Issued in IL

Practice address

US Hwy 491 North
Shiprock, NM 87420

Phone

(505) 368-6001

Fax

(505) 368-6360

NPI assigned

Jul 8, 2014

Last updated

Sep 27, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

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.

• A. Garrett Berley D.D.S.

  • General Practice Dentistry
  • Oakbrook Terrace, IL
  • NPI 1548277684
  NPD (past)
• James W Skoumal DDS PC

  • Dental Clinic/Center
  • Oakbrook Terrace, IL
  • NPI 1093483281
  NPD (past)

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1932515293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874200160",
            "telephone_number": "505-368-6001",
            "fax_number": "505-368-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 491 NORTH",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-6001",
            "fax_number": "505-368-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDATTO",
        "first_name": "KRUPA",
        "middle_name": "PATEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.029869",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.029869",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roseline Boateng
• Laura Bodnar
• Floyd P Bond, MD
• Jennifer L Bongartz, PHARMD
• Daniel Bordatto, DMD
• Michelle Rae Brandser, MAC, LPCC, LADAC
• Patricia A Breeden, MD
• Marie Brown-Wagner, MD
• Arlene Nakai Brown, MA
• Judy L Brown, PAC

• Dentist in Shiprock, NM
• Providers in Shiprock, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.