NPIMap

Organization Active NPI

Matthew Pendergrass DDS PA

  • Dentist
  • Germantown, MD
National Provider Identifier
1164646105
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8008 Issued in MD
Legal business name
MATTHEW PENDERGRASS DDS PA
Practice address
22710 Ridge Road
Germantown, MD 20876
Phone
(301) 972-3444
Fax
(301) 972-4948
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Matthew Philip Pendergrass, DDSNPI 1225054158
Title
President
Phone
(301) 972-3444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 8008 MD Primary

Addresses

Primary practice location

22710 Ridge Road
Germantown, MD 20876

Mailing address

22710 Ridge Road
Germantown, MD 20876
Phone (301) 972-3444

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.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164646105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22710 RIDGE ROAD",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "20876",
            "telephone_number": "301-972-3444",
            "fax_number": "301-972-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22710 RIDGE ROAD",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "20876",
            "telephone_number": "301-972-3444",
            "fax_number": "301-972-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW PENDERGRASS DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENDERGRASS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-972-3444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "8008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.