Magnolia Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MAGNOLIA DENTAL, LLC

Practice address

10208 Lake Arbor Way
Mitchellville, MD 20721

Phone

(301) 485-5463

NPI assigned

Jul 21, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Dawn L Tyler, DDS

Title

Dentist

Phone

(301) 485-5463

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1532131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560729600000",
    "number": "1043797152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10208 LAKE ARBOR WAY",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207213113",
            "telephone_number": "301-485-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10208 LAKE ARBOR WAY",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "20721",
            "telephone_number": "301-485-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-21",
        "last_updated": "2019-06-17",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "301-485-5463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifetime Dental Care of Maryland, Badger, P.C.
• Richard Marvin Lipscomb, DDS
• Anastasia Liu, DPT
• Brittney Mabry, BCBA
• Rodney Mackey Jr.
• Asek Nelson Makia, M.D.
• Brooke Denaye Marshall, PT
• Sonia E Martin Samuels, DDS
• Kayla K McDonald, P.T.
• Megan Noelle McGloin

• General Practice Dentistry in Mitchellville, MD
• Providers in Mitchellville, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.