Individual provider Active NPI

Rajat Diwan, D.D.S.,

  • General Practice Dentistry
  • Georgetown, TX
National Provider Identifier
1538467618
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27926 Issued in TX
Practice address
2411 Williams Dr Ste 111
Georgetown, TX 78628-3268
Phone
(877) 800-5722
NPI assigned
Mar 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 27926 TX Primary

Addresses

Primary practice location

2411 Williams Dr Ste 111
Georgetown, TX 78628-3268

Mailing address

2423 Williams Dr Ste 107
Georgetown, TX 78628-3269
Phone (877) 800-5722

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rajat.diwan.p1@direct.lscctx.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210211000601 TX Practitioner - Dentist 7719295195 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27926TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Circle of Care CurrentSince Mar 1, 2021 Accepting new patients
Lone Star Circle of Care Current Accepting new patients
Lone Star Circle of Care CurrentSince Mar 1, 2021 Accepting new patients
Bee Country Modern Dentistry and Orthodontics, PC Past Accepting new patients

Locations

1221 W Ben White Blvd
Ste 200B
Austin, TX 78704
Phone (512) 524-9249

2411 Williams Dr
Ste 111
Georgetown, TX 78628
Phone (512) 864-1445

205 E University Ave
Ste 200
Georgetown, TX 78626
Phone (512) 686-0207

2423 Williams Dr
Ste 107
Georgetown, TX 78628
Phone (512) 686-0207

2423 Williams Dr
Georgetown, TX 78628
Phone (512) 341-8908

Interoperability endpoints

  • Direct secure messaging: rajat.diwan.1@29821.direct.athenahealth.com

Organizations & group practices 4

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": "1300060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1538467618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283269",
            "telephone_number": "877-800-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 WILLIAMS DR STE 111",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283268",
            "telephone_number": "877-800-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIWAN",
        "first_name": "RAJAT",
        "credential": "D.D.S.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-14",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rajat.diwan.p1@direct.lscctx.nextgenshare.com",
            "affiliation": "N",
            "address_1": "2411 Williams Dr Ste 111",
            "city": "Georgetown",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786283268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.