Active NPI
Kelly Ganzen
- Dentist
- Bethesda, MD
National Provider Identifier
1922679943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1922679943
- Practice address
- 8955 Wood Road
Building 1
Bethesda, MD 20899 - Phone
- (301) 295-0064
- NPI assigned
- Jul 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1922679943 | UT | Primary |
Addresses
Primary practice location
8955 Wood Road
Building 1
Bethesda, MD 20899
Mailing address
8015 Old Georgetown Rd Apt 737
Bethesda, MD 20814-2590
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220718002257 | UT | Order and Referring Only - Dentist | 4385025659 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1922679943 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1922679943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8015 OLD GEORGETOWN RD APT 737",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208142590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8955 WOOD ROAD",
"address_2": "BUILDING 1",
"city": "BETHESDA",
"state": "MD",
"postal_code": "20899",
"telephone_number": "301-295-0064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANZEN",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-09",
"last_updated": "2026-07-15",
"certification_date": "2026-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "1922679943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.