Individual provider Active NPI

Jilna Raichura, RDH, MS

  • Dental Hygienist
  • Rockville, MD
National Provider Identifier
1518724319
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
5358 Issued in MD
Practice address
16815 Crabbs Branch Way
Rockville, MD 20855-2215
Phone
(301) 963-4330
NPI assigned
Feb 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 5358 MD Primary

Addresses

Primary practice location

16815 Crabbs Branch Way
Rockville, MD 20855-2215

Mailing address

4412 Skymist Ter
Olney, MD 20832-2824
Phone (202) 262-4870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5358MDMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Manlucu Dental Group PC CurrentSince Nov 10, 2024 Accepting new patients

Locations

16815 Crabbs Branch Way
Rockville, MD 20855
Phone (301) 963-4330

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1518724319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4412 SKYMIST TER",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208322824",
            "telephone_number": "202-262-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16815 CRABBS BRANCH WAY",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208552215",
            "telephone_number": "301-963-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAICHURA",
        "first_name": "JILNA",
        "credential": "RDH, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MD",
            "license": "5358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.