Dr Mitra Derakhshan, DDS MS - Dentist in Ellicott City, MD

Dr Mitra Derakhshan, DDS MS is a Dentist - Orthodontics And Dentofacial Orthopedics based in Ellicott City, Maryland. Dr Mitra Derakhshan is licensed to practice in Maryland (license number 12731) and her current practice location is 5082 Dorsey Hall Dr Ste 202, Ellicott City, Maryland. She can be reached at her office (for appointments etc.) via phone at (202) 445-4972.

NPI number for Dr Mitra Derakhshan is 1962916783 and her current mailing address is 794 Grant St, Herndon, Virginia. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1962916783.

Contact Information

Dr Mitra Derakhshan, DDS MS
5082 Dorsey Hall Dr Ste 202,
Ellicott City, MD 21042-7754
(202) 445-4972
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDr Mitra Derakhshan
GenderFemale
SpecialityDentist - Orthodontics And Dentofacial Orthopedics
Location5082 Dorsey Hall Dr Ste 202, Ellicott City, Maryland
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1962916783
  • Provider Enumeration Date: 12/01/2017
  • Last Update Date: 03/17/2018

Medical Identifiers

Medical identifiers for Dr Mitra Derakhshan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1962916783NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223X0400XDentist - Orthodontics And Dentofacial Orthopedics DEN1000677 (District Of Columbia)Secondary
1223X0400XDentist - Orthodontics And Dentofacial Orthopedics 49090 (California)Secondary
1223X0400XDentist - Orthodontics And Dentofacial Orthopedics 12731 (Maryland)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mitra Derakhshan is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Mitra Derakhshan, DDS MS
794 Grant St,
Herndon, VA 20170-4631

Ph: () -
Dr Mitra Derakhshan, DDS MS
5082 Dorsey Hall Dr Ste 202,
Ellicott City, MD 21042-7754

Ph: (202) 445-4972

Reviews and Comments


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