Mayura K Ginde, DDS

Individual provider Active NPI Dentist · Glenshaw, PA

NPI 1841481371 · NPPES record last updated Aug 8, 2007

Key facts

NPI
1841481371
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
DS037133 (PA)
Practice address
1724 Mount Royal Blvd
Glenshaw, PA 15116-2115
Phone
(412) 213-1999
Fax
(412) 213-6985
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160229001975 PA Order and Referring Only - Other (Physician)
Practitioner - Other (Physician)
5799080735

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS037133 PA Yes

Addresses

Primary practice location

1724 Mount Royal Blvd
Glenshaw, PA 15116-2115

Mailing address

926 Great Pond Dr
Suite 2003
Altamonte Springs, FL 32714-7244
Phone (407) 772-5124

Other names

  • Mayura Ramesh Pradhan Former name

Other providers in Glenshaw, PA

All providers in Glenshaw, PA · Dentist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.