Individual provider Active NPI

Rupan Pandove, DDS

  • Dentist
  • Baltimore, MD
National Provider Identifier
1871942250
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
16107 Issued in MD
Practice address
1501 Division St
Baltimore, MD 21217
Phone
(410) 383-8300
Fax
(410) 383-3160
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS102130 CA
Dentist 122300000X 16107 MD Primary

Addresses

Primary practice location

1501 Division St
Baltimore, MD 21217

Mailing address

12029 Floating Clouds Path
Clarksville, MD 21029-1678
Phone (909) 389-8662

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191113002171 MD Practitioner - Dentist 9931531969 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS102130CAMDDentist
16107MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Health Care Inc. CurrentSince Nov 1, 2019 Accepting new patients
Total Health Care Inc CurrentSince Nov 1, 2019 Accepting new patients
Total Health Care Inc Current Accepting new patients

Locations

1501 W Saratoga St
Baltimore, MD 21223
Phone (410) 383-7197

1501 Division St
Baltimore, MD 21217
Phone (410) 735-5390

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GJFJBD

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": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1871942250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12029 FLOATING CLOUDS PATH",
            "city": "CLARKSVILLE",
            "state": "MD",
            "postal_code": "210291678",
            "telephone_number": "909-389-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 DIVISION ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21217",
            "telephone_number": "410-383-8300",
            "fax_number": "410-383-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDOVE",
        "first_name": "RUPAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS102130",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "16107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.