Individual provider Active NPI

Karishma Patel, DMD

  • Public Health Dentistry
  • Clarksville, TN
National Provider Identifier
1942985841
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
12216 Issued in TN
Practice address
1466 Tiny Town Rd Ste a
Clarksville, TN 37042-8292
Phone
(931) 548-0119
NPI assigned
Jun 19, 2023
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 12216 TN Primary

Addresses

Primary practice location

1466 Tiny Town Rd Ste a
Clarksville, TN 37042-8292

Mailing address

313 Longshadow TRL Unit E
Clarksville, TN 37043-8090
Phone (843) 680-4901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20231004001801 TN Order and Referring Only - DentistPractitioner - Dentist 0446605836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12216TNMDPublic Health Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarksville Modern Dentistry,PC PastSince Jun 1, 2023 Accepting new patients
Tiny Town Smiles Dentistry, PC PastSince Jul 23, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1942985841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 LONGSHADOW TRL UNIT E",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438090",
            "telephone_number": "843-680-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1466 TINY TOWN RD STE A",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370428292",
            "telephone_number": "931-548-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KARISHMA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "TN",
            "license": "12216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.