Provider Demographics
NPI:1235026964
Name:PIKESVILLE DENTAL ASSOCIATES
Entity type:Organization
Organization Name:PIKESVILLE DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DHARANI
Authorized Official - Middle Name:
Authorized Official - Last Name:JASTHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-898-6788
Mailing Address - Street 1:3635 OLD COURT RD STE 510
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3916
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3635 OLD COURT RD STE 510
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3916
Practice Address - Country:US
Practice Address - Phone:443-898-6788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-24
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental