Pancholi Dental LLC

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

PANCHOLI DENTAL LLC

Practice address

3450 Laurel Fort Meade Rd Ste 202
Laurel, MD 20724-2040

Phone

(443) 763-0754

NPI assigned

Nov 18, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Shivakshi Pancholi, DDSNPI 1215601638

Title

Dentist

Phone

(443) 763-0754

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shivakshi Bina Pancholi, DDS

  • Dentist
  • Catonsville, MD
  • NPI 1215601638
  NPD Authorized official

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1366267148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7207 BARRY LN",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755486",
            "telephone_number": "443-763-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 LAUREL FORT MEADE RD STE 202",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207242040",
            "telephone_number": "443-763-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANCHOLI DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "PANCHOLI",
        "authorized_official_first_name": "SHIVAKSHI",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "443-763-0754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Pak, CPNP
• Christina Palermo, LMSW
• Tanya Regine Pallia, PA-C
• Pamela Lynn Palmer
• Sneha Pampati, M.D.
• Paradise Home Care LLC.
• Paragon Home Health Services, LLC
• Ashley Parham-Phillips
• Patrice Paris, LCPC
• Stacey Pariseault

• Public Health Dentistry in Laurel, MD
• Providers in Laurel, MD by specialty
• Public Health Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.