Frederick Kidds Pediatric Dentistry LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

14079 Issued in MD

Legal business name

FREDERICK KIDDS PEDIATRIC DENTISTRY LLC

Practice address

211 Shorebird St Ste B
Frederick, MD 21701-1963

Phone

(301) 202-5041

NPI assigned

Jul 14, 2015

Organization subpart

No

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

Authorized official

Name

D'Audra Cole, DDS

Title

Dentist/Owner

Phone

(301) 202-5041

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Kelly Granger, DDS

  • Pediatric Dentistry
  • Falls Church, VA
  • NPI 1497489744
  NPD (past)

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436832000000",
    "number": "1043694623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SHOREBIRD ST STE B",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217011963",
            "telephone_number": "301-202-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SHOREBIRD ST STE B",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217011963",
            "telephone_number": "301-202-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK KIDDS PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-14",
        "last_updated": "2015-07-14",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "D'AUDRA",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "301-202-5041",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "14079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1194880633",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frederick Imaging Centers, LLC
• Frederick Institute
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• Frederick Integrative Metabolic Psychiatry and Counseling, P.C.
• Frederick Internal Medicine and Endocrinology Services, PA
• Frederick Kidney Care Associates
• Frederick Kidney Care Associates LLC.
• Frederick Medical & Pulmonary Assoc
• Frederick Memorial Hospital Inc
• Frederick Memorial Hospital Inc

• Pediatric Dentistry in Frederick, MD
• Providers in Frederick, MD by specialty
• Pediatric Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.