Provider Demographics
NPI:1417077959
Name:JASTHI, DHARANI (DMD)
Entity Type:Individual
Prefix:DR
First Name:DHARANI
Middle Name:
Last Name:JASTHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 N ROLLING RD
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4136
Mailing Address - Country:US
Mailing Address - Phone:410-744-7777
Mailing Address - Fax:410-744-7795
Practice Address - Street 1:832 N ROLLING RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4136
Practice Address - Country:US
Practice Address - Phone:410-744-7777
Practice Address - Fax:410-744-7795
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD122101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice