Manisha K Chawla

Primary specialty

DentistTaxonomy code 122300000X

License

15989 Issued in MD

Practice address

3460 Old Washington Rd
Suite 102
Waldorf, MD 20602-3240

Phone

(301) 638-1420

NPI assigned

Jul 13, 2015

Last updated

Jul 13, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dental & Prosthodontics Rehab Inc.

  dba Waldorf Cosmetic & Implant Dentistry

  • Dental Clinic/Center
  • Waldorf, MD
  • NPI 1932489523
  NPD (past)

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1790169308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S EADS ST",
            "address_2": "APT 819",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222023027",
            "telephone_number": "202-207-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 OLD WASHINGTON RD",
            "address_2": "SUITE 102",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023240",
            "telephone_number": "301-638-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAWLA",
        "first_name": "MANISHA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15989",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414906",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1001517",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edner Charles, PMHNP-BC
• Marie Fayette Charles, CRNP-FNP-PMHNP-BC
• Charleston Grove, LLC (The Charleston Senior Community)
• Charm City Orthotics & Prosthetics
• Mansi Chavan
• Love Ngum Che, PHARMD
• Chesapeake Anesthesia Partners LLC
• Chesapeake Eye Care & Laser Center LLC
• Chesapeake Eye Care & Laser Center LLC
• Chesapeake Eye Care and Laser Center, LLC

• Dentist in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.

Verify at the official NPI Registry.