Longmeadow Family Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12508 Issued in MD

Legal business name

LONGMEADOW FAMILY DENTAL CARE

Practice address

19638 Leitersburg Pike
Suite 103
Hagerstown, MD 21742

Phone

(301) 739-1100

NPI assigned

Aug 18, 2006

Last updated

Nov 8, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brandon Keith Ellis, DDSNPI 1578679643

Title

Pres/Owner

Phone

(301) 739-1100

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brandon Keith Ellis, DDS

  • Dentist
  • Hagerstown, MD
  • NPI 1578679643
  NPD (past) Authorized official

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510099200000",
    "number": "1174637185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19638 LEITERSBURG PIKE",
            "address_2": "SUITE 103",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421438",
            "telephone_number": "301-739-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19638 LEITERSBURG PIKE",
            "address_2": "SUITE 103",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21742",
            "telephone_number": "301-739-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGMEADOW FAMILY DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2017-11-08",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PRES/OWNER",
        "authorized_official_telephone_number": "301-739-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14739",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "12508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Loeb, MD
• Donna E Lofton, C.N.M.
• Jaime Long, PTA
• Toby Allison Long, LCPC, NCC
• Longmeadow Eyecare Incorporated
• Kimberly Ann Longo
• Taryn Christine Longstreth, PA-C
• Fern Elizabeth Loomis, R.N.
• Karin Looper, NP
• Daisy Lopez-Duke, LCPC

• General Practice Dentistry in Hagerstown, MD
• Providers in Hagerstown, 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 Nov 8, 2017; 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.