Individual provider Active NPI

Anuj Patel, DDS

  • Dentist
  • Bloomington, IN
National Provider Identifier
1952297210
Registry record updated Jun 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12014791A Issued in IN
Practice address
330 N Jacob Dr
Bloomington, IN 47404-4823
Phone
(812) 323-7400
NPI assigned
Jun 14, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12014791A IN Primary

Addresses

Primary practice location

330 N Jacob Dr
Bloomington, IN 47404-4823

Mailing address

2222 S Pennsylvania St
Indianapolis, IN 46225-1912
Phone (317) 331-5167

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12014791AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
LK Dental, LLC CurrentSince Jun 15, 2025 Accepting new patients
CS Dental LLC PastSince Jun 15, 2025 Accepting new patients

Locations

330 N Jacob Dr
Bloomington, IN 47404
Phone (812) 323-7400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749859200000",
    "number": "1952297210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S PENNSYLVANIA ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462251912",
            "telephone_number": "317-331-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N JACOB DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474044823",
            "telephone_number": "812-323-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ANUJ",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-14",
        "last_updated": "2025-06-14",
        "certification_date": "2025-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12014791A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2025; 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.