NPIMap

Organization Active NPI

Dental Professionals of Maryland, Badger, P.C.

  • General Practice Dentistry
  • Laurel, MD
National Provider Identifier
1154631075
Registry record updated Nov 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF MARYLAND, BADGER, P.C.
Practice address
7500 Montpelier Rd Ste 108
Laurel, MD 20723-6012
Phone
(301) 617-0880
Fax
(301) 617-0817
NPI assigned
Oct 13, 2010
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 6, 2021

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

Authorized official

Name
Carmen Woods
Title
Insurance/Credentialing
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

7500 Montpelier Rd Ste 108
Laurel, MD 20723-6012

Mailing address

7500 Montpelier Rd Ste 108
Laurel, MD 20723-6012
Phone (301) 617-0880

Other names 2

  • FDC - Maple Lawn Doing business as
  • Fulton Family Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lifetime Dental Care of Maryland Badger PC16 organizations share this tax ID, including this one
Part of
Lifetime Dental Care of Maryland Badger PC

Other organizations with this tax ID 15

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

View all 15

Locations

7500 Montpelier Rd
Ste 108
Laurel, MD 20723
Phone (301) 617-0880

Practitioners & affiliated clinicians

Practitioners 3

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": "1286928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636156800000",
    "number": "1154631075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 MONTPELIER RD STE 108",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207236012",
            "telephone_number": "301-617-0880",
            "fax_number": "301-617-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 MONTPELIER RD STE 108",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207236012",
            "telephone_number": "301-617-0880",
            "fax_number": "301-617-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF MARYLAND, BADGER, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, PC",
        "enumeration_date": "2010-10-13",
        "last_updated": "2021-11-06",
        "certification_date": "2021-11-06",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "INSURANCE/CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FDC - Maple Lawn",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FDC - Maple Lawn",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fulton Family Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2021; 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.