DR. MITRA DERAKHSHAN DDS MS
NPI 1962916783
Dentist - Orthodontics and Dentofacial Orthopedics in Ellicott City, MD

Active since December 01, 2017
5082 DORSEY HALL DR STE 202, ELLICOTT CITY, MD 21042(202) 445-4972 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 17, 2018, Dec 1, 2017 (2 updates tracked since 2017).

About Dr. Mitra Derakhshan Dds Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MITRA DERAKHSHAN DDS MS (NPI 1962916783) is an individual orthodontics and dentofacial orthopedics provider in Ellicott City, Maryland, licensed in Maryland (12731) and active in the NPI registry since December 2017. She maintains a secondary practice location in Clarksville.

NPPES Registry Identity

NPI1962916783
Entity TypeIndividualFemale
Primary Taxonomy1223X0400X
Provider Legal NameDR. MITRA DERAKHSHANCredential: DDS MS
Location Address5082 DORSEY HALL DR STE 202Ellicott City, MD 21042-7754
Mailing Address794 Grant StHerndon, VA 20170-4631
Sole ProprietorNo
Enumeration DateDecember 1, 2017
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
NPI 1962916783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
Licenses Licensed in MD · 12731 Licensed in DC · DEN1000677 Licensed in CA · 49090
Definition

That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.

5082 DORSEY HALL DR STE 202, Ellicott City, MD 21042

Secondary Practice Location 1

Location 15820 Clarksville Square Dr Ste 104Clarksville, MD 21029-1856 · Phone (202) 445-4972

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Dentist (Orthodontics and Dentofacial Orthopedics)
5082 DORSEY HALL DR STE 202
ELLICOTT CITY, MD 21042
Dentist (Orthodontics and Dentofacial Orthopedics)
5082 DORSEY HALL DR STE 202
ELLICOTT CITY, MD 21042

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1962916783, enumerated as an "individual" on December 01, 2017.

The provider is located at 5082 DORSEY HALL DR STE 202 ELLICOTT CITY, MD 21042 and the phone number is (202) 445-4972.

Dentist with taxonomy code 1223X0400X and a focus in Orthodontics and Dentofacial Orthopedics.