Individual provider Active NPI

Mary Elizabeth Rondeau, DDS

  • Prosthodontics
  • Fort Meade, MD
National Provider Identifier
1003019829
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
16909 Issued in MD
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

Updated by the provider on Aug 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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 Other name

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

LicenseStateTypeSpecialty
16909MDMDMarriage & Family Therapist
023867-1NYMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Epes Dental Clinic General Practice PastSince Aug 27, 2023 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.

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.

Verify at the official NPI Registry.