Mitra Davaninejad, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

16403 Issued in MD

Practice address

4959 Westview Dr Ste F
Frederick, MD 21703-7369

Phone

(240) 815-6949

NPI assigned

Jun 28, 2017

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104347301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18931 HIGHSTREAM DR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208746168",
            "telephone_number": "240-643-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4959 WESTVIEW DR STE F",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037369",
            "telephone_number": "240-815-6949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18931 Highstream Dr",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "MD",
            "postal_code": "208746168",
            "country_code": "US",
            "telephone_number": "240-643-4228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVANINEJAD",
        "first_name": "MITRA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "16403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Taylor Darrah, DPT
• Danielle J Dasilva, LMSW
• Kristen Lee Dasilva
• Jaclyn Blaire Daugherty, CRNP-PMH
• Jennifer Davamony
• Prafull K Dave, MD PA
• Katie Davella, LCPC
• Davick Enterprise,LLC
• David a. Lieb
• David J Levine DPM C Ped

• Dentist in Frederick, MD
• Providers in Frederick, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.