Individual provider Active NPI

Chikara Jamila Saunders-Fiddermon, DDS

  • Pediatric Dentistry
  • Lanham, MD
National Provider Identifier
1063733830
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
14916 Issued in MD
Practice address
2830 Campus Way N Ste 614
Lanham, MD 20706-1669
Phone
(301) 955-9198
NPI assigned
Jun 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0401415345 VA
Pediatric Dentistry 1223P0221X DDS-10042 IA
Pediatric Dentistry 1223P0221X 14916 MD Primary

Addresses

Primary practice location

2830 Campus Way N Ste 614
Lanham, MD 20706-1669

Mailing address

5108 Jersey Ridge Rd Ste B
Davenport, IA 52807-3133
Phone (633) 550-4375

Other practice location 1

10113 Ward Rd
Dunkirk, MD 20754-2717
Phone (301) 327-3314

Other practice location 2

600 Pemberton Browns Mills Rd
Pemberton, NJ 08068-1537
Phone (609) 894-1213

Other names 1

  • Dr. Chikara Jamila Saunders Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DDS-10042IAMDPediatric Dentist
14916MDMDPediatric Dentist
0401415345VAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater LLC Past Accepting new patients
Tidewater LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1063733830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 JERSEY RIDGE RD STE B",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073133",
            "telephone_number": "633-550-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 CAMPUS WAY N STE 614",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207061669",
            "telephone_number": "301-955-9198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10113 Ward Rd",
            "address_purpose": "LOCATION",
            "city": "Dunkirk",
            "state": "MD",
            "postal_code": "207542717",
            "country_code": "US",
            "telephone_number": "301-327-3314",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Pemberton Browns Mills Rd",
            "address_purpose": "LOCATION",
            "city": "Pemberton",
            "state": "NJ",
            "postal_code": "080681537",
            "country_code": "US",
            "telephone_number": "609-894-1213",
            "fax_number": "609-894-1219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAUNDERS-FIDDERMON",
        "first_name": "CHIKARA",
        "middle_name": "JAMILA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-16",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401415345",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IA",
            "license": "DDS-10042",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "14916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHIKARA",
            "last_name": "SAUNDERS",
            "middle_name": "JAMILA",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.