NPIMap

Organization Active NPI

Myorthos Maryland Orthodontics-Labbe PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Clarksville, MD
National Provider Identifier
1104586742
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
MYORTHOS MARYLAND ORTHODONTICS-LABBE PC
Practice address
12230 Clarksville Pike
Clarksville, MD 21029-1477
Phone
(410) 381-1077
NPI assigned
Dec 22, 2021
Organization subpart
Yes
Parent organization
MYORTHOS MARYLAND ORTHODONTICS-LABBE PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Casey Lonabocker
Title
VP Operations & Strategy
Phone
(617) 535-3364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

12230 Clarksville Pike
Clarksville, MD 21029-1477

Mailing address

131 Dartmouth St FL 3
Boston, MA 02116-5297

Other practice location 1

8191 Maple Lawn Blvd
Fulton, MD 20759-2534
Phone (410) 381-1077

Other names 1

  • Vanguard Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Myorthos Maryland Orthodontics-Labbe PC6 organizations share this tax ID, including this one
Part of
Myorthos Maryland Orthodontics-Labbe PC

Other organizations with this tax ID 5

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

Locations

12230 Clarksville Pike
Clarksville, MD 21029
Phone (410) 381-1077

8191 Maple Lawn Blvd
Fulton, MD 20759
Phone (410) 381-1077

NPI Registry JSON

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

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1104586742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 DARTMOUTH ST FL 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12230 CLARKSVILLE PIKE",
            "city": "CLARKSVILLE",
            "state": "MD",
            "postal_code": "210291477",
            "telephone_number": "410-381-1077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8191 Maple Lawn Blvd",
            "address_purpose": "LOCATION",
            "city": "Fulton",
            "state": "MD",
            "postal_code": "207592534",
            "country_code": "US",
            "telephone_number": "410-381-1077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MYORTHOS MARYLAND ORTHODONTICS-LABBE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MYORTHOS MARYLAND ORTHODONTICS-LABBE PC",
        "enumeration_date": "2021-12-22",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "LONABOCKER",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "VP OPERATIONS & STRATEGY",
        "authorized_official_telephone_number": "617-535-3364"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vanguard Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vanguard Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.