Healthcare Provider Details

I. General information

NPI: 1881065613
Provider Name (Legal Business Name): KRISHNA JANI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6505 BELCREST RD STE D105
HYATTSVILLE MD
20782-2011
US

IV. Provider business mailing address

6505 BELCREST RD STE 105
HYATTSVILLE MD
20782-2011
US

V. Phone/Fax

Practice location:
  • Phone: 301-559-5435
  • Fax:
Mailing address:
  • Phone: 301-559-5435
  • Fax: 301-559-5435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN1000088
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: