Active NPI
Heta S Jasani
- General Practice Dentistry
- Clinton, MD
National Provider Identifier
1568894459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 15369
- Practice address
- 8913 Woodyard Rd
Clinton, MD 20735-4257 - Phone
- (301) 363-2336
- NPI assigned
- Aug 2, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 15369 | MD | Primary |
Addresses
Primary practice location
8913 Woodyard Rd
Clinton, MD 20735-4257
Mailing address
8913 Woodyard Rd
Clinton, MD 20735-4257
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170105000627 | VA | Order and Referring Only - Dentist | 6901187954 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15369 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380758400000",
"number": "1568894459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8913 WOODYARD RD",
"city": "CLINTON",
"state": "MD",
"postal_code": "207354257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8913 WOODYARD RD",
"city": "CLINTON",
"state": "MD",
"postal_code": "207354257",
"telephone_number": "301-363-2336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JASANI",
"first_name": "HETA",
"middle_name": "S",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-02",
"last_updated": "2013-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "15369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.