Individual provider Active NPI

Gita Tajick, DDS

  • General Practice Dentistry
  • Laurel, MD
National Provider Identifier
1700970647
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12338 Issued in MD
Practice address
9101 Cherry LN
Suite 202
Laurel, MD 20708-1133
Phone
(301) 776-3300
Fax
(301) 725-1372
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 12338 MD Primary

Addresses

Primary practice location

9101 Cherry LN
Suite 202
Laurel, MD 20708-1133

Mailing address

9101 Cherry LN
Suite 202
Laurel, MD 20708-1133
Phone (301) 776-3300

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160610000234 MD Order and Referring Only - DentistPractitioner - Dentist 8628368206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12338MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Rosenberg & Tajick General Practice Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700970647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 CHERRY LN",
            "address_2": "SUITE 202",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207081133",
            "telephone_number": "301-776-3300",
            "fax_number": "301-725-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 CHERRY LN",
            "address_2": "SUITE 202",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207081133",
            "telephone_number": "301-776-3300",
            "fax_number": "301-725-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJICK",
        "first_name": "GITA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "12338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.