Organization Active NPI

Ben Manesh DDS PC IV

  • General Practice Dentistry
  • Gaithersburg, MD
National Provider Identifier
1508911041
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10772 Issued in MD
Legal business name
BEN MANESH DDS PC IV
Practice address
237 Kentlands Blvd
Gaithersburg, MD 20878-5446
Phone
(301) 987-5200
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Roxana Homayoun
Title
Managing Partner
Phone
(301) 987-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 10772 MD Primary

Addresses

Primary practice location

237 Kentlands Blvd
Gaithersburg, MD 20878-5446

Mailing address

237 Kentlands Blvd
Gaithersburg, MD 20878-5446
Phone (301) 987-5200

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508911041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 KENTLANDS BLVD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785446",
            "telephone_number": "301-987-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 KENTLANDS BLVD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785446",
            "telephone_number": "301-987-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEN MANESH DDS PC IV",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOMAYOUN",
        "authorized_official_first_name": "ROXANA",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "301-987-5200"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "10772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.