DR. CHETAN SHYAM PATIL (NPI# 1548598576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548598576 |
| Entity Type | Individual |
| Full Name | DR. CHETAN SHYAM PATIL |
| Credential | DDS |
| Practice Address |
97 N Dean St Englewood NJ 07631-2806 |
| Mailing Address |
904 Jefferson St Apt 6k Hoboken NJ 07030-9207 |
| Practice Telephone | 2015677766 |
| Mailing Telephone | 2014682692 |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2015-06-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
22DI02429400 | NJ | Dental Providers |
| N | 1223P0300X |
Dentist Specialization: Periodontics |
053823 | NY | Dental Providers |
| Street Address |
97 N DEAN ST |
| City | ENGLEWOOD |
| State | NJ |
| Zip Code | 07631-2806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659440402 | Periodontal Associates | Dentist | 97 N Dean St, Englewood, NJ 07631-2806 | 2006-11-07 |
| 1710109376 | Theodore Lee West | Dentist | 97 N Dean St, Englewood, NJ 07631-2806 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447868922 | Sharmela Brijmohan | Student in an Organized Health Care Education/Training Program | 350 Engle Street Englewood Nj Department of Medicine, Englewood, NJ 07631 | 2020-07-21 |
| 1902422553 | Ross Tyrone Jensen Lavine | Student in an Organized Health Care Education/Training Program | 350 Engle Street, Department of Medicine, Englewood, NJ 07631 | 2020-06-19 |
| 1881235497 | Cbt and Psychodynamic Therapy Associates LLC | Social Worker | 245 Walnut Street, Englewood, NJ 07631 | 2019-10-04 |
| 1346895950 | Eb Care At Englewood, LLC | Assisted Living Facility | 412 South Van Brunt Street, Englewood, NJ 07631 | 2019-08-09 |
| 1730695727 | Maytal Elart | Spec/Tech, Cardiovascular | 151 E Palisades Ave, 16e, Englewood, NJ 07631 | 2017-12-28 |
| 1396259255 | Elizabeth Thottumalil Thomas | Counselor | 93 West Palisade Ave, Englewood, NJ 07631 | 2017-11-29 |
| 1992214381 | Englewood Orthopedics Group PC | Orthopaedic Surgery | 55 Smith St Unit 5653, Englewood, NJ 07631 | 2017-09-28 |
| 1639691579 | Jee Hoon Jang | Student in an Organized Health Care Education/Training Program | 350 Engle St., Englewood, NJ 07631 | 2017-07-12 |
| 1427570332 | Dan Ran Castillo | Student in an Organized Health Care Education/Training Program | 350 Engel Street, Engelwood, NJ 07631 | 2017-07-12 |
| 1275061392 | Thomas J Drexler | Counselor | 93 W. Palisades Ave, Englewood, NJ 07631 | 2017-06-02 |
| Find all providers in zip 07631 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972910107 | Yoojun Park | Dentist | 401a South Van Brunt St Ste 205, Englewood, NJ 07631-4979 | 2014-07-21 |
| 1275743106 | Rebecca Ilene Subin-schneebaum | Dentist | 20 W Ivy Ln, Englewood, NJ 07631-2121 | 2007-05-22 |
| 1659440402 | Periodontal Associates | Dentist | 97 N Dean St, Englewood, NJ 07631-2806 | 2006-11-07 |
| 1942385216 | David Kallus | Dentist | 335 Maple St, Englewood, NJ 07631-3705 | 2006-10-26 |
| 1710109376 | Theodore Lee West | Dentist | 97 N Dean St, Englewood, NJ 07631-2806 | 2007-05-03 |
| 1306857065 | Mark Jankowski | Dentist | 3601 S Clarkson St, Suite #330, Englewood, CO 80113-3944 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114559994 | Daniela Gurpegui Abud | Dentist | 100 Park Ave Apt Ph4j, Fort Lee, NJ 07024-3806 | 2020-02-10 |
| 1417502378 | Periodontal Consultants, Pa | Dentist | 1910 East Marlton Pike, The Atrium Suite #2, Cherry Hill, NJ 08003 | 2019-08-07 |
| 1104478189 | Meera Sahni | Dentist | 3069 English Creek Ave Ste 101, Egg Harbor Township, NJ 08234-9708 | 2019-07-10 |
| 1245896364 | Edward Feins Dmd, Pa | Dentist | 241 Rivervale Road, River Vale, NJ 07675 | 2019-05-14 |
| 1437636917 | Noam L Saltzburg | Dentist | 738 Park Ave, Elizabeth, NJ 07208-1349 | 2018-07-26 |
| 1912406745 | Terri Anne Binder | Dentist | Eisai Inc, 155 Tice Blvd, Woodcliff Lake, NJ 07677-8406 | 2018-02-07 |
| 1548771967 | Leonard Swerdlof | Dentist | 160 S Broad St, Ridgewood, NJ 07450 | 2017-10-12 |
| 1801326111 | Mina Ebrahimi Daryani | Dentist | 1307 White Horse Rd Ste B100, Voorhees, NJ 08043-2156 | 2017-06-19 |
| 1689129942 | Alejandro Castano | Dentist | 16 Pocono Rd Ste 213, Denville, NJ 07834 | 2016-08-16 |
| 1275932006 | Javier Sanz Moliner | Dentist | 103 Mansfield Rd E, Columbus, NJ 08022-2108 | 2014-08-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.