Individual provider Active NPI

Ritika Bansal

  • Dentist
  • Washington, DC
National Provider Identifier
1790262079
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN123053 Issued in GA
Practice address
3401 Georgia Ave NW
Washington, DC 20010-2501
Phone
(202) 829-5437
Fax
(202) 829-9255
NPI assigned
Jul 19, 2018
Last updated
May 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12264 CT
Dentist 122300000X DEN2000027 DC
Dentist 122300000X DN123053 GA Primary

Addresses

Primary practice location

3401 Georgia Ave NW
Washington, DC 20010-2501

Mailing address

197 Judith LN Apt 1
Waterbury, CT 06704-1944
Phone (317) 650-8604

Other practice location 1

94 Connecticut Blvd
East Hartford, CT 06108-3013
Phone (860) 528-1359

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
I20190221000859 CT Order and Referring Only - DentistPractitioner - Dentist 9931447711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN2000027DCMDDentist
DN123053GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1790262079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 JUDITH LN APT 1",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067041944",
            "telephone_number": "317-650-8604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 GEORGIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102501",
            "telephone_number": "202-829-5437",
            "fax_number": "202-829-9255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 Connecticut Blvd",
            "address_purpose": "LOCATION",
            "city": "East Hartford",
            "state": "CT",
            "postal_code": "061083013",
            "country_code": "US",
            "telephone_number": "860-528-1359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "RITIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "12264",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN2000027",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN123053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.