NPIMap

Organization Active NPI

Potomac Dental Clinic, Inc.

  • General Practice Dentistry
  • Rockville, MD
National Provider Identifier
1093136160
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13885 Issued in MD
Legal business name
POTOMAC DENTAL CLINIC, INC.
Doing business as
Potomac Dental Clinic, Inc.
Practice address
5862 Hubbard Dr
Rockville, MD 20852-4820
Phone
(301) 984-4040
Fax
(301) 984-4419
NPI assigned
Dec 17, 2013
Last updated
Dec 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Authorized official

Name
Dr. Parvaneh Sajjadi, D.D.S.NPI 1598188807
Title
President
Phone
(301) 984-4040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13885 MD Primary

Addresses

Primary practice location

5862 Hubbard Dr
Rockville, MD 20852-4820

Mailing address

5862 Hubbard Dr
Rockville, MD 20852-4820
Phone (301) 984-4040

Other names 1

  • Potomac Dental Clinic, Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Potomac Dental Clinic Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

5862 Hubbard Dr
Rockville, MD 20852
Phone (301) 984-4040

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1093136160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5862 HUBBARD DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524820",
            "telephone_number": "301-984-4040",
            "fax_number": "301-984-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5862 HUBBARD DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524820",
            "telephone_number": "301-984-4040",
            "fax_number": "301-984-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC DENTAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "SAJJADI",
        "authorized_official_first_name": "PARVANEH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-984-4040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potomac Dental Clinic, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.