Rahul Mehta, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS045112 Issued in PA

Practice address

767 5TH Ave
Chambersburg, PA 17201-4207

Phone

(717) 709-7940

NPI assigned

Feb 22, 2025

Last updated

Aug 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Keystone Rural Health Center

  dba Keystone Dental Care Fifth Avenue

  • Federally Qualified Health Center (FQHC)
  • Chambersburg, PA
  • NPI 1124026703
  NPD (past)

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

{
    "created_epoch": "1740182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1053117747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CHAMBERS HILL DR STE 200",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172017304",
            "telephone_number": "717-709-7922",
            "fax_number": "717-263-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 5TH AVE",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014207",
            "telephone_number": "717-709-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "RAHUL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-22",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS045112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med Tel International Corporation (Wide Open Imaging)
• Medexpress Urgent Care, PC - Pennsylvania (MedExpress Urgent Care - Chambersburg)
• Medical Practices of Antietam LLC
• Medical Practices of Antietam LLC
• Luis Augusto Medina Mora, M.D.
• Michael Meketon, L.C.S.W.
• Kevin R Mello, BS
• Daniele Nicole Mellott-Lamar, LPC
• Alexis Mellott
• Emily Renee Mellott, CRNA

• Dentist in Chambersburg, PA
• Providers in Chambersburg, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.