Active NPI
Ernest Devan Ponraj, DDS
- Dentist
- Rockville, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14719
- Practice address
- 4 Taft CT Ste 150
Rockville, MD 20850-5582 - Phone
- (301) 598-7800
- Fax
- (301) 963-6300
- NPI assigned
- Nov 24, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401412323 | VA | |
| Dentist | 122300000X | DEN1001069 | DC | |
| Dentist | 122300000X | 14719 | MD | Primary |
Addresses
Primary practice location
4 Taft CT Ste 150
Rockville, MD 20850-5582
Mailing address
4 Taft CT Ste 150
Rockville, MD 20850-5582
Phone (301) 598-7800
Other practice location 1
2277 Bel Pre Rd
Suite #212
Silver Spring, MD 20906-2200
Phone (301) 598-7800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- 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 |
|---|---|---|---|---|
| I20160725000057 | MD | Order and Referring Only - Dentist | 5496048746 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN1001069 | DC | MD | Dentist |
| 0401412323 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bel Pre Family Dental LLC | Current | Accepting new patients |
Locations
4 Taft Ct
Ste 150
Rockville, MD 20850
Phone (301) 598-7800
2277 Bel Pre Rd
Ste 212
Silver Spring, MD 20906
Phone (301) 598-7800
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": "1259020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730937600000",
"number": "1700114097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 TAFT CT STE 150",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208505582",
"telephone_number": "301-598-7800",
"fax_number": "301-963-6300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 TAFT CT STE 150",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208505582",
"telephone_number": "301-598-7800",
"fax_number": "301-963-6300"
}
],
"practiceLocations": [
{
"address_1": "2277 Bel Pre Rd",
"address_2": "Suite #212",
"address_purpose": "LOCATION",
"city": "Silver Spring",
"state": "MD",
"postal_code": "209062200",
"country_code": "US",
"telephone_number": "301-598-7800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PONRAJ",
"first_name": "ERNEST",
"middle_name": "DEVAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-24",
"last_updated": "2024-11-07",
"certification_date": "2024-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401412323",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "DC",
"license": "DEN1001069",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "14719",
"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 Nov 7, 2024; 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.