Special Care Dental of Pennsylvania-CKK LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SPECIAL CARE DENTAL OF PENNSYLVANIA-CKK LLC

Practice address

11974 Edgehill Terrace Rd
Princess Anne, MD 21853-2105

Phone

(502) 244-2420

Fax

(502) 996-8282

NPI assigned

Jul 6, 2022

Organization subpart

No

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

Authorized official

Name

Joy L Stevens

Title

Director of Revenue

Phone

(502) 244-2441

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher Krzysztof Krowicki, D.D.S.

  • Dentist
  • Philadelphia, PA
  • NPI 1043308646
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1003549288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 SHELBYVILLE RD STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432404",
            "telephone_number": "502-813-4415",
            "fax_number": "502-996-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11974 EDGEHILL TERRACE RD",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218532105",
            "telephone_number": "502-244-2420",
            "fax_number": "502-996-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIAL CARE DENTAL OF PENNSYLVANIA-CKK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE",
        "authorized_official_telephone_number": "502-244-2441"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Somerset Physical Therapy
• Somerset PT
• Somerset Weight and Sleep Management
• Sonny Senior Care Assisted Living LLC
• Zaidat Soule-Abou
• Jon R Spence, PHARMACIST
• Charles Donald Stegman Jr., MD
• Step Up From Grace
• Marie T Swartz, PT
• Tiffany A Swift, LCSW-C

• Dentist in Princess Anne, MD
• Providers in Princess Anne, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.