Ajay Ganti, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

35033 Issued in TX

Practice address

2300 W FM 544 Ste 240
Wylie, TX 75098-4931

Phone

(469) 596-7722

Fax

(469) 596-7720

NPI assigned

Apr 1, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 10, 2022 through Jun 10, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Jawomfs, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Atlanta, GA
  • NPI 1326479544
  NPD (past)

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1508008855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W FM 544 STE 240",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750984931",
            "telephone_number": "469-596-7722",
            "fax_number": "469-596-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W FM 544 STE 240",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750984931",
            "telephone_number": "469-596-7722",
            "fax_number": "469-596-7720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 Peachtree Pkwy",
            "address_2": "Suite 340",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417236",
            "country_code": "US",
            "telephone_number": "404-433-8433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANTI",
        "first_name": "AJAY",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "35033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033759584",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508008855",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Owusu Fordjour
• Sandra Burgess Foreman, LBSW
• Maichelle White Francis
• Christopher M G'Sell, DDS
• John David Gambill, LCDC, LPC
• Deanna Garcia, P.A.
• Jaivy Garcia, RN
• Michael A Garcia, RN
• Mikayla Garcia
• Ashley Gardner, MD

• Oral and Maxillofacial Surgery (Dentist) in Wylie, TX
• Providers in Wylie, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.