Active NPI
Mary Elizabeth Rondeau, DDS
- Prosthodontics
- Fort Meade, MD
National Provider Identifier
1003019829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 16909
- Practice address
- 8472 Simmond St
Fort Meade, MD 20755-5700 - Phone
- (301) 677-6078
- NPI assigned
- Jun 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 16909 | MD | |
| Dental Hygienist | 124Q00000X | 023867-1 | NY | |
| Prosthodontics | 1223P0700X | 16909 | MD | Primary |
Addresses
Primary practice location
8472 Simmond St
Fort Meade, MD 20755-5700
Mailing address
8476 Simmond St
Fort George G Meade, MD 20755-7083
Phone (301) 677-6122
Other practice location 1
8901 Rockville Pike
Bethesda, MD 20889-0001
Phone (301) 295-4000
Other practice location 2
1 Jarrett White Rd
ATTN: Credentials Office
Tripler Amc, HI 96859-5001
Phone (808) 433-1021
Other names 1
- Dr. Mary Elizabeth Smith
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16909 | MD | MD | Marriage & Family Therapist |
| 023867-1 | NY | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epes Dental Clinic | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Fort Meade, MD
- NPI 1437186343
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1003019829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8476 SIMMOND ST",
"city": "FORT GEORGE G MEADE",
"state": "MD",
"postal_code": "207557083",
"telephone_number": "301-677-6122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8472 SIMMOND ST",
"city": "FORT MEADE",
"state": "MD",
"postal_code": "207555700",
"telephone_number": "301-677-6078"
}
],
"practiceLocations": [
{
"address_1": "8901 Rockville Pike",
"address_purpose": "LOCATION",
"city": "Bethesda",
"state": "MD",
"postal_code": "208890001",
"country_code": "US",
"telephone_number": "301-295-4000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Jarrett White Rd",
"address_2": "ATTN: Credentials Office",
"address_purpose": "LOCATION",
"city": "Tripler Amc",
"state": "HI",
"postal_code": "968595001",
"country_code": "US",
"telephone_number": "808-433-1021",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RONDEAU",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-08",
"last_updated": "2023-08-14",
"certification_date": "2023-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "16909",
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NY",
"license": "023867-1",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MD",
"license": "16909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "SMITH",
"middle_name": "ELIZABETH",
"prefix": "DR.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Fort Meade, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.