Organization Active NPI

Kidz & Family Dental Center

  • Dental Clinic/Center
  • Wheaton, MD
National Provider Identifier
1144628868
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
15191 Issued in MD
Legal business name
KIDZ & FAMILY DENTAL CENTER
Practice address
11933 Georgia Ave
Wheaton, MD 20902
Phone
(954) 826-8785
NPI assigned
Dec 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Authorized official

Name
Parisa Nemati
Title
Owner
Phone
(954) 826-8785

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 15191 MD Primary
Dental Clinic/Center 261QD0000X 15167 MD

Addresses

Primary practice location

11933 Georgia Ave
Wheaton, MD 20902

Mailing address

11933 Georgia Ave
Wheaton, MD 20902
Phone (954) 826-8785

Other identifiers 2

IdentifierTypeStateIssuer
669761334MedicaidMD
061340100MedicaidMD

National Provider Directory

National Provider Directory

Locations

11933 Georgia Ave
Wheaton, MD 20902
Phone (301) 200-8015

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1144628868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11933 GEORGIA AVE",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "20902",
            "telephone_number": "954-826-8785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11933 GEORGIA AVE",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "20902",
            "telephone_number": "954-826-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ & FAMILY DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A",
        "authorized_official_last_name": "NEMATI",
        "authorized_official_first_name": "PARISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-826-8785"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MD",
            "license": "15191",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MD",
            "license": "15167",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "669761334",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061340100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.