Individual provider Active NPI

Nevatha Mathialagan, DDS

  • Dentist
  • Washington, DC
National Provider Identifier
1821755596
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN2000473 Issued in DC
Practice address
2155 Champlain St NW
Washington, DC 20009-2795
Phone
(202) 540-9857
Fax
(202) 232-8494
NPI assigned
Nov 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN2000473 DC Primary

Addresses

Primary practice location

2155 Champlain St NW
Washington, DC 20009-2795

Mailing address

4 Atlantic St SW
Washington, DC 20032-2350
Phone (202) 470-3080

Other identifiers 1

IdentifierTypeStateIssuer
087395363MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230926000172 RI Practitioner - Dentist 8325492341 Reassigns benefits to 1 organization
I20250220003472 DC Practitioner - Dentist 8325492341 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13248CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wood River Health Services, Inc. CurrentSince Aug 13, 2023 Accepting new patients
Community of Hope, Inc. CurrentSince Feb 14, 2025 Accepting new patients
Community of Hope Inc. CurrentSince Feb 14, 2025 Accepting new patients

Locations

4 Atlantic St SW
Washington, DC 20032
Phone (202) 407-3080

2155 Champlain St NW
Washington, DC 20009
Phone (202) 407-3080

823 Main St
Hope Valley, RI 02832

17 Wells St
Westerly, RI 02891
Phone (401) 348-2020

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1821755596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ATLANTIC ST SW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200322350",
            "telephone_number": "202-470-3080",
            "fax_number": "202-232-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 CHAMPLAIN ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092795",
            "telephone_number": "202-540-9857",
            "fax_number": "202-232-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIALAGAN",
        "first_name": "NEVATHA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN2000473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087395363",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.