Dentrust Dental Maryland, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTRUST DENTAL MARYLAND, P.A.

Practice address

999 Crouse Mill Rd
Keymar, MD 21757-9109

Phone

(866) 916-6447

Fax

(844) 751-0258

NPI assigned

Feb 9, 2021

Last updated

Feb 9, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jodie Lynn Bickley

Title

Credentialing

Phone

(866) 916-6447

Specialties & licenses 1

Addresses

Tax ID family

Dentrust Dental Maryland PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Dentrust Dental Maryland, P.a.

  dba DOCS Dental Ft. Meade

  • General Practice Dentistry
  • Fort George G Meade, MD
  • NPI 1811602907
  NPD tax ID
• Dentrust Dental Maryland, P.a.

  • General Practice Dentistry
  • Pipersville, PA
  • NPI 1578006201
  NPD tax ID

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612828800000",
    "number": "1043802242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6097 EASTON RD",
            "city": "PIPERSVILLE",
            "state": "PA",
            "postal_code": "189471810",
            "telephone_number": "866-916-6447",
            "fax_number": "844-751-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 CROUSE MILL RD",
            "city": "KEYMAR",
            "state": "MD",
            "postal_code": "217579109",
            "telephone_number": "866-916-6447",
            "fax_number": "844-751-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTRUST DENTAL MARYLAND, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A",
        "authorized_official_last_name": "BICKLEY",
        "authorized_official_first_name": "JODIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "866-916-6447"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Marshall Chop
• Katie Kinna, LCSW-C
• Emily Koubek, LMSW
• Rite of Passage Inc (Silver Oak Academy)
• Silver Oak Academy, Inc.

• General Practice Dentistry in Keymar, MD
• Providers in Keymar, 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 Feb 9, 2021; 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.