PG Plaze Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PG PLAZE DENTAL

Practice address

3500 E West Hwy
The Mall at Prince George
Hyattsville, MD 20782-1916

Phone

(301) 933-9300

NPI assigned

Jun 24, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Rostislav Krasnov, DDS

Title

Owner

Phone

(301) 933-9300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403568000000",
    "number": "1164837654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 E WEST HWY",
            "address_2": "THE MALL AT PRINCE GEORGE",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207821916",
            "telephone_number": "301-933-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 E WEST HWY",
            "address_2": "THE MALL AT PRINCE GEORGE",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207821916",
            "telephone_number": "301-933-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PG PLAZE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A",
        "authorized_official_last_name": "KRASNOV",
        "authorized_official_first_name": "ROSTISLAV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-933-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Perrin
• Letea Nerice Perry, ED.D.
• Monique Perry, SOCIAL WORKER
• Personalized Spine and Pain Care
• Marcelle Rabiatou Petsouonko
• Van Thanh Pham
• Maria Phillip
• Physician'S Mobile X-Ray, Inc
• Physician'S Mobile X-Ray, Inc
• Christine Pimagam Nguekam, HHA

• General Practice Dentistry in Hyattsville, MD
• Providers in Hyattsville, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.