NPIMap

Organization Active NPI

Potomac Dental Clinic, Inc.

  • General Practice Dentistry
  • Rockville, MD
National Provider Identifier
1104988492
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
POTOMAC DENTAL CLINIC, INC.
Practice address
5884 Hubbard Dr
Rockville, MD 20852-4821
Phone
(301) 984-4040
Fax
(301) 984-4419
NPI assigned
Dec 14, 2006
Last updated
Jan 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Authorized official

Name
Dr. Parvaneh Afshar 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 with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

5884 Hubbard Dr
Rockville, MD 20852-4821

Mailing address

5884 Hubbard Dr
Rockville, MD 20852-4821
Phone (301) 984-4040

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

5884 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": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1104988492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5884 HUBBARD DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524821",
            "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": "5884 HUBBARD DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524821",
            "telephone_number": "301-984-4040",
            "fax_number": "301-984-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC DENTAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "SAJJADI",
        "authorized_official_first_name": "PARVANEH",
        "authorized_official_middle_name": "AFSHAR",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 7, 2014; 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.