NPIMap

Organization Active NPI

Gaithersburg Dental Associates

  • Dental Clinic/Center
  • Gaithersburg, MD
National Provider Identifier
1124423462
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
13266 Issued in MD
Legal business name
GAITHERSBURG DENTAL ASSOCIATES
Practice address
8 Russell Ave
Suite 104
Gaithersburg, MD 20877-2966
Phone
(301) 869-2500
Fax
(301) 926-7655
NPI assigned
Oct 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Authorized official

Name
Dr. Mandana Goodarzi1 Logmanni, D.D.S.
Title
Owner/President
Phone
(301) 869-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 13266 MD Primary

Addresses

Primary practice location

8 Russell Ave
Suite 104
Gaithersburg, MD 20877-2966

Mailing address

8 Russell Ave
Suite 104
Gaithersburg, MD 20877-2966
Phone (301) 869-2500

Other names 1

  • Logmanni Dental Associates Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Gaithersburg Dental Associate PA2 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.

NPI Registry JSON

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1124423462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 RUSSELL AVE",
            "address_2": "SUITE 104",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772966",
            "telephone_number": "301-869-2500",
            "fax_number": "301-926-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 RUSSELL AVE",
            "address_2": "SUITE 104",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772966",
            "telephone_number": "301-869-2500",
            "fax_number": "301-926-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAITHERSBURG DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "LOGMANNI",
        "authorized_official_first_name": "MANDANA",
        "authorized_official_middle_name": "GOODARZI1",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "301-869-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MD",
            "license": "13266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logmanni Dental Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.