NPIMap

Organization Active NPI

Dora Mamodesene,MD,PC

  • Primary Care Clinic/Center
  • Washington, DC
National Provider Identifier
1144454141
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
14222MD Issued in DC
Legal business name
DORA MAMODESENE,MD,PC
Practice address
7733 Alaska Ave NW
NW
Washington, DC 20012-1421
Phone
(202) 882-5300
Fax
(301) 989-2276
NPI assigned
May 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Authorized official

Name
Dr. Dora M Mamodesene, MDNPI 1508807298
Title
President
Phone
(202) 489-1277

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 14222MD DC Primary
Primary Care Clinic/Center 261QP2300X D0029649MD MD
Primary Care Clinic/Center 261QP2300X 0101035678 VA

Addresses

Primary practice location

7733 Alaska Ave NW
NW
Washington, DC 20012-1421

Mailing address

2057 Mayflower Dr
Silver Spring, MD 20905-5564
Phone (202) 498-1277

Other identifiers 1

IdentifierTypeStateIssuer
000148491OtherMDMEDICARE

National Provider Directory

National Provider Directory

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": "1241568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1144454141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2057 MAYFLOWER DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209055564",
            "telephone_number": "202-498-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7733 ALASKA AVE NW",
            "address_2": "NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200121421",
            "telephone_number": "202-882-5300",
            "fax_number": "301-989-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DORA MAMODESENE,MD,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-06",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "MAMODESENE",
        "authorized_official_first_name": "DORA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "202-489-1277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "DC",
            "license": "14222MD",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": "D0029649MD",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0101035678",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "000148491",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.