Individual provider Active NPI

Shital Patel, DDS

  • General Practice Dentistry
  • Corona, CA
National Provider Identifier
1942396734
Registry record updated Jun 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
45308 Issued in CA
Practice address
1185 Magnolia Ave
Suite K
Corona, CA 92879-3218
Phone
(951) 898-8511
Fax
(951) 898-8591
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2015

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 45308 CA Primary

Addresses

Primary practice location

1185 Magnolia Ave
Suite K
Corona, CA 92879-3218

Mailing address

260 E Ontario Ave
Ste 201
Corona, CA 92879-3506
Phone (951) 898-8511

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
45308CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Shital Patel D.D.S. & Rakesh Patel D.D.S., Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1942396734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E ONTARIO AVE",
            "address_2": "STE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793506",
            "telephone_number": "951-898-8511",
            "fax_number": "951-898-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 MAGNOLIA AVE",
            "address_2": "SUITE K",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793218",
            "telephone_number": "951-898-8511",
            "fax_number": "951-898-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHITAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; 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.