North Beach Dental Care, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

14033 Issued in MD

Legal business name

NORTH BEACH DENTAL CARE, LLC

Practice address

5570 Shady Side Rd Ste a
Churchton, MD 20733-9639

Phone

(443) 550-8115

NPI assigned

May 19, 2014

Organization subpart

No

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

Authorized official

Name

Nathaniel Ford

Title

Practice Manager

Phone

(443) 550-8115

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400457600000",
    "number": "1174934699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5570 SHADY SIDE RD STE A",
            "city": "CHURCHTON",
            "state": "MD",
            "postal_code": "207339639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5570 SHADY SIDE RD STE A",
            "city": "CHURCHTON",
            "state": "MD",
            "postal_code": "207339639",
            "telephone_number": "443-550-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BEACH DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-19",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "443-550-8115"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "14033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Churchton, MD
• Providers in Churchton, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.