Antietam Orthodontics

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

ANTIETAM ORTHODONTICS

Practice address

322 E Antietam St
Suite103
Hagerstown, MD 21740-5794

Phone

(301) 733-1552

Fax

(301) 733-1553

NPI assigned

Sep 1, 2011

Organization subpart

No

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

Authorized official

Name

Paul Thomas Thomopulos, DDS.,MDS

Title

Owner

Phone

(301) 733-1552

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1033490263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 E ANTIETAM ST",
            "address_2": "SUITE103",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405794",
            "telephone_number": "301-733-1552",
            "fax_number": "301-733-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 E ANTIETAM ST",
            "address_2": "SUITE103",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405794",
            "telephone_number": "301-733-1552",
            "fax_number": "301-733-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTIETAM ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "THOMOPULOS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-733-1552",
        "authorized_official_credential": "DDS.,MDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Antietam Surgeons Charles R Chaney MD PA
• Antietam Urosurgical Center LLC ASC
• Lauryn Antolock

• Orthodontics and Dentofacial Orthopedics Dentistry in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.