NPIMap

Organization Active NPI

CCDC Professionals, LLC

Doing business as Baltimore Children's General Anesthesia Dentistry

  • Dental Clinic/Center
  • Baltimore, MD
National Provider Identifier
1083363410
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CCDC PROFESSIONALS, LLC
Doing business as
Baltimore Children's General Anesthesia Dentistry
Practice address
3421 Benson Ave Ste G100
Baltimore, MD 21227-1134
Phone
(301) 494-3000
NPI assigned
Mar 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Authorized official

Name
Jeffrey Wheeler
Title
Ceo
Phone
(301) 494-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3421 Benson Ave Ste G100
Baltimore, MD 21227-1134

Mailing address

1220 Caraway CT Ste 1050
Upper Marlboro, MD 20774-5338
Phone (301) 494-3000

Other names 1

  • Baltimore Children's General Anesthesia Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Capital Children's General Anesthesia Dentistry3 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.

NPI Registry JSON

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786924800000",
    "number": "1083363410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 CARAWAY CT STE 1050",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745338",
            "telephone_number": "301-494-3000",
            "fax_number": "301-494-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 BENSON AVE STE G100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212271134",
            "telephone_number": "301-494-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCDC PROFESSIONALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-22",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-494-3000"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baltimore Children's General Anesthesia Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.