Laurel Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

LAUREL PEDIATRIC DENTISTRY

Doing business as

Laurel Lakes Cosmetic Dentistry

Practice address

13916 Baltimore Ave
Laurel, MD 20707-5009

Phone

(301) 498-6511

NPI assigned

Oct 17, 2014

Last updated

Oct 17, 2014By 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

Dr. Michelle Stovall, DDS

Title

Pediatric Dentistry

Phone

(240) 441-2193

Specialties & licenses 1

Addresses

Other names 1

• Laurel Lakes Cosmetic Dentistry Doing business as

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1053715268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13916 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075009",
            "telephone_number": "301-498-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13916 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075009",
            "telephone_number": "301-498-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "STOVALL",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PEDIATRIC DENTISTRY",
        "authorized_official_telephone_number": "240-441-2193",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laurel Lakes Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laurel Main Street Pharmacy Incorporated (Main Street Pharmacy)
• Laurel MD Endoscopy ASC LLC (Ambulatory Endoscopy Center of Maryland)
• Laurel Medical Associates, LLC
• Laurel Medical Center Pharmacy Inc
• Laurel Orthopedic & Medical Supplies, Inc
• Laurel Pediatrics
• Laurel Pharmacy II LLC (LAUREL PHARMACY Rt 1)
• Laurel Pine Pediatrics LLC
• Laurel Pines Dental 100 LLC
• Laurel Pines Dental Group, Chartered (Laurel Pines Dental Group)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.