NPIMap

Organization Active NPI

La Plata Dental, LLC

  • Dentist
  • La Plata, MD
National Provider Identifier
1104270073
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LA PLATA DENTAL, LLC
Practice address
105 Centennial St
Suite C
La Plata, MD 20646-6943
Phone
(240) 349-2439
NPI assigned
Apr 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Authorized official

Name
Andrew Betaharon, DDS
Title
Owner
Phone
(240) 349-2439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

105 Centennial St
Suite C
La Plata, MD 20646-6943

Mailing address

105 Centennial St
Suite C
La Plata, MD 20646-6943

National Provider Directory

National Provider Directory

Locations

105 Centennial St
Ste C
La Plata, MD 20646
Phone (240) 349-2439

NPI Registry JSON

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460937600000",
    "number": "1104270073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CENTENNIAL ST",
            "address_2": "SUITE C",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206466943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CENTENNIAL ST",
            "address_2": "SUITE C",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206466943",
            "telephone_number": "240-349-2439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PLATA DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "BETAHARON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-349-2439",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Plata, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.