NPIMap

Organization Active NPI

Chetna K. Desai, D.D.S, P.C.

  • Dentist
  • Ellicott City, MD
National Provider Identifier
1154415073
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12204 Issued in MD
Legal business name
CHETNA K. DESAI, D.D.S, P.C.
Practice address
3290 N. Ridge Road
Suite #180
Ellicott City, MD 21043
Phone
(410) 480-9111
Fax
(410) 480-9133
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Authorized official

Name
Dr. Chetna Kartik Desai, D.D.SNPI 1013034891
Title
President
Phone
(410) 480-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12204 MD Primary

Addresses

Primary practice location

3290 N. Ridge Road
Suite #180
Ellicott City, MD 21043

Mailing address

PO Box 450
Ellicott City, MD 21041-0450
Phone (410) 480-9111

Other identifiers 1

IdentifierTypeStateIssuer
008749100MedicaidMD

Other names 1

  • Desai Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

3290 North Ridge Rd
Ste 180
Ellicott City, MD 21043
Phone (410) 480-9111

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1154415073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 450",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210410450",
            "telephone_number": "410-480-9111",
            "fax_number": "410-480-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 N. RIDGE ROAD",
            "address_2": "SUITE #180",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21043",
            "telephone_number": "410-480-9111",
            "fax_number": "410-480-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHETNA K. DESAI, D.D.S, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "CHETNA",
        "authorized_official_middle_name": "KARTIK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-480-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "12204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008749100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desai Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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.