Individual provider Active NPI

Raji Ganesh, DMD

  • General Practice Dentistry
  • Audubon, PA
National Provider Identifier
1811203391
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS037836 Issued in PA
Practice address
2785 Egypt Road
Audubon, PA 19403
Phone
(610) 631-5800
NPI assigned
Aug 23, 2010
Last updated
May 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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 DS037836 PA Primary

Addresses

Primary practice location

2785 Egypt Road
Audubon, PA 19403

Mailing address

4 Casselberry Dr
Audubon, PA 19403
Phone (215) 681-0410

Other practice location 1

309 Gravel Pike
Collegeville, PA 19426-1835
Phone (610) 489-1313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150901002913 PA Order and Referring Only - DentistPractitioner - Dentist 9830405141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS037836PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Experts Inc CurrentSince Apr 20, 2025 Accepting new patients
Community Medical & Dental Center General Practice Past Accepting new patients

Locations

2785 Egypt Rd
Audubon, PA 19403
Phone (610) 631-5800

Organizations & group practices 2

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": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1811203391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CASSELBERRY DR",
            "city": "AUDUBON",
            "state": "PA",
            "postal_code": "19403",
            "telephone_number": "215-681-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2785 EGYPT ROAD",
            "city": "AUDUBON",
            "state": "PA",
            "postal_code": "19403",
            "telephone_number": "610-631-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Gravel Pike",
            "address_purpose": "LOCATION",
            "city": "Collegeville",
            "state": "PA",
            "postal_code": "194261835",
            "country_code": "US",
            "telephone_number": "610-489-1313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANESH",
        "first_name": "RAJI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Audubon, PA

Sources for this page

Verify at the official NPI Registry.