Provider Demographics
NPI:1255535886
Name:MAHAJAN, DIPTY (DMD, PA)
Entity type:Individual
Prefix:DR
First Name:DIPTY
Middle Name:
Last Name:MAHAJAN
Suffix:
Gender:F
Credentials:DMD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16216 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-1204
Mailing Address - Country:US
Mailing Address - Phone:240-543-5495
Mailing Address - Fax:
Practice Address - Street 1:9850 KEY WEST AVE STE 302
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3904
Practice Address - Country:US
Practice Address - Phone:301-838-9300
Practice Address - Fax:301-838-9304
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13815122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty