Rock Kids Dental LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

ROCK KIDS DENTAL LLC

Practice address

1631 Crofton Ctr
Crofton, MD 21114-1343

Phone

(410) 774-0221

Fax

(410) 774-0251

NPI assigned

Jan 13, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Irene Ebunoluwa Apata, DDSNPI 1831452648

Title

Pediatric Dentist/Owner

Phone

(410) 774-0221

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Rock Kids Dental Doing business as

Locations

Practitioners 1

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

• Irene Ebunoluwa Apata, D.D.S

  • Pediatric Dentistry
  • Crofton, MD
  • NPI 1831452648
  NPD Authorized official

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1164136149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 CROFTON CTR",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141343",
            "telephone_number": "410-774-0221",
            "fax_number": "410-774-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 CROFTON CTR",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141343",
            "telephone_number": "410-774-0221",
            "fax_number": "410-774-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK KIDS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "APATA",
        "authorized_official_first_name": "IRENE",
        "authorized_official_middle_name": "EBUNOLUWA",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST/OWNER",
        "authorized_official_telephone_number": "410-774-0221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831452648",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "D76904",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056005700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rock Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jane Priscilla Roach, CRNP
• Dara Georgeann Robinette, M.S. CCC-SLP
• Mary Lee Robinson
• Samantha Robinson
• Amanda Robles, MA, LCPC
• Clare Marie Rodgers, CRNP
• Glynnis Rodgers
• Salena Rosa, COSMETOLOGIST
• Nancy Theresa Rose, R.N.
• Kimberly Nielsen Rosenbaum

• Pediatric Dentistry in Crofton, MD
• Providers in Crofton, MD by specialty
• Pediatric Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.