Active NPI
Madhumitha Ambalavanan, DMD
- Dentist
- Ellicott City, MD
National Provider Identifier
1659601656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14348
- Practice address
- 9200 Baltimore National Pike
Ellicott City, MD 21042-2613 - Phone
- (410) 480-9800
- NPI assigned
- Jan 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 14348 | MD | Primary |
Addresses
Primary practice location
9200 Baltimore National Pike
Ellicott City, MD 21042-2613
Mailing address
9200 Baltimore National Pike
Ellicott City, MD 21042-2613
Phone (606) 454-1052
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698364800000",
"number": "1659601656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 BALTIMORE NATIONAL PIKE",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210422613",
"telephone_number": "606-454-1052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 BALTIMORE NATIONAL PIKE",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210422613",
"telephone_number": "410-480-9800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBALAVANAN",
"first_name": "MADHUMITHA",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-13",
"last_updated": "2023-10-27",
"certification_date": "2023-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "14348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.