NPIMap

Organization Active NPI

Lifetime Dental Care of Maryland, Badger, P.C.

Doing business as Lifetime Dental Care of Frostburg

  • General Practice Dentistry
  • Frostburg, MD
National Provider Identifier
1023617321
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LIFETIME DENTAL CARE OF MARYLAND, BADGER, P.C.
Doing business as
Lifetime Dental Care of Frostburg
Practice address
151 Bishop Murphy Dr Ste a
Frostburg, MD 21532-1476
Phone
(301) 689-6780
NPI assigned
Oct 19, 2020
Organization subpart
Yes
Parent organization
LIFETIME DENTAL CARE OF MARYLAND, BADGER, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

151 Bishop Murphy Dr Ste a
Frostburg, MD 21532-1476

Mailing address

151 Bishop Murphy Dr Ste a
Frostburg, MD 21532-1476

Other names 1

  • Lifetime Dental Care of Frostburg Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lifetime Dental Care of Maryland Badger PC12 organizations share this tax ID, including this one
Part of
Lifetime Dental Care of Maryland Badger PC

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

151 Bishop Murphy Dr
Ste A
Frostburg, MD 21532
Phone (301) 689-6780

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1023617321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 BISHOP MURPHY DR STE A",
            "city": "FROSTBURG",
            "state": "MD",
            "postal_code": "215321476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 BISHOP MURPHY DR STE A",
            "city": "FROSTBURG",
            "state": "MD",
            "postal_code": "215321476",
            "telephone_number": "301-689-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME DENTAL CARE OF MARYLAND, BADGER, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFETIME DENTAL CARE OF MARYLAND, BADGER, P.C.",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Dental Care of Frostburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frostburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.