Individual provider Active NPI

Kunal C Patel, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Dallas, TX
National Provider Identifier
1942793476
Registry record updated Jun 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
34041 Issued in TX
Practice address
3302 Gaston Ave
Dallas, TX 75246-2013
Phone
(214) 828-8445
NPI assigned
Jun 9, 2018
Last updated
Jun 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 34041 TX Primary

Addresses

Primary practice location

3302 Gaston Ave
Dallas, TX 75246-2013

Mailing address

821 Allen St Apt 736
Dallas, TX 75204-5891
Phone (702) 501-9895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230711004363 MO Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 1153655618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Univ of Nevada, Las Vegas School of Dental Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Surgical Arts LLCGroup PAC ID 5193132975, 7 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 16a
Saint Louis, MO 63141-8239
Phone (314) 251-6725

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34041TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Surgical Arts, LLC CurrentSince Jul 1, 2023 Accepting new patients
Clarkson Oral Surgery Oral and Maxillofacial Surgery Past Accepting new patients
Michael W. Noble, DMD, PC Oral and Maxillofacial Surgery Past Accepting new patients

Locations

2997 Clarkson Rd
Ste 120
Chesterfield, MO 63017
Phone (636) 400-6725

60 E North St
Eureka, MO 63025
Phone (636) 938-6725

2747 W Clay St
Saint Charles, MO 63301
Phone (314) 862-0700

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

621 S New Ballas Rd
Ste 1
Saint Louis, MO 63141
Phone (314) 251-6725

621 S New Ballas Rd
Ste 16A
Saint Louis, MO 63141
Phone (314) 251-6725

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1528502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528502400000",
    "number": "1942793476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 ALLEN ST APT 736",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752045891",
            "telephone_number": "702-501-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462013",
            "telephone_number": "214-828-8445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KUNAL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-09",
        "last_updated": "2018-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "34041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.