Individual provider Active NPI

Ashu Malhotra, DDS

  • General Practice Dentistry
  • Davenport, IA
National Provider Identifier
1770865404
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8877 Issued in IA
Practice address
5270 Elmore Ave Ste 4
Davenport, IA 52807-3466
Phone
(563) 209-9000
NPI assigned
Sep 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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 8877 IA Primary

Addresses

Primary practice location

5270 Elmore Ave Ste 4
Davenport, IA 52807-3466

Mailing address

171 Grandview Ave Ste 103
Waterbury, CT 06708-2519
Phone (860) 569-9996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240528002593 CT Practitioner - Dentist 6103122668 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8877IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Institute for Communities Inc Current Accepting new patients
Connecticut Institute for Communities Inc CurrentSince Apr 20, 2024 Accepting new patients
Patel-Shah Dental Iowa PLLC General Practice PastSince Apr 23, 2023 Accepting new patients
LM Smiles PLLC General Practice Past Accepting new patients
Connecticut Institute for Communities Inc Past Accepting new patients

Locations

120 Main St
Danbury, CT 06810
Phone (203) 456-1406

57 North St
Ste 103
Danbury, CT 06810
Phone (203) 744-7007

120 Main St
Fl 4
Danbury, CT 06810
Phone (203) 456-1405

Organizations & group practices 5

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": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1770865404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 GRANDVIEW AVE STE 103",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082519",
            "telephone_number": "860-569-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5270 ELMORE AVE STE 4",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073466",
            "telephone_number": "563-209-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALHOTRA",
        "first_name": "ASHU",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "8877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.