Smile Loft North Potomac LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SMILE LOFT NORTH POTOMAC LLC

Practice address

12116 Darnestown Rd Ste L1
North Potomac, MD 20878-2227

Phone

(301) 258-7477

NPI assigned

Jan 17, 2023

Organization subpart

No

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

Authorized official

Name

Vaibhav Rai

Title

Member

Phone

(610) 216-0339

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1093420713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12116 DARNESTOWN RD STE L1",
            "city": "NORTH POTOMAC",
            "state": "MD",
            "postal_code": "208782227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12116 DARNESTOWN RD STE L1",
            "city": "NORTH POTOMAC",
            "state": "MD",
            "postal_code": "208782227",
            "telephone_number": "301-258-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE LOFT NORTH POTOMAC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "RAI",
        "authorized_official_first_name": "VAIBHAV",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "610-216-0339"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046068200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fadime Seremet
• Habibatu Kemoh Sesay, PMHNP
• Hee J Seung, L. AC.
• Robert Shugoll, PH.D.
• Cynthia Siegel
• Beth Ann Smith, LICSW
• Daniel Edward Snow, MD
• Fatemeh Soltanmohammadi
• Elysa Sontheimer, LCSW-C
• Ming Soo Hoo, P.T.

• General Practice Dentistry in North Potomac, MD
• Providers in North Potomac, 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 Jan 17, 2023; 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.