Provider Demographics
NPI:1366255424
Name:OMEGA DENTAL GROUP LLC
Entity type:Organization
Organization Name:OMEGA DENTAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIPTY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:240-543-5495
Mailing Address - Street 1:806 W DIAMOND AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1470
Mailing Address - Country:US
Mailing Address - Phone:301-838-9300
Mailing Address - Fax:301-838-9304
Practice Address - Street 1:806 W DIAMOND AVE STE 330
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1470
Practice Address - Country:US
Practice Address - Phone:301-838-9300
Practice Address - Fax:301-838-9304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty