NPIMap

Organization Active NPI

Pdom Forest Hills LLC

  • Dentist
  • Forest Hill, MD
National Provider Identifier
1184963977
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PDOM FOREST HILLS LLC
Practice address
2003 Rock Spring Rd
Forest Hill, MD 21050-2611
Phone
(410) 838-1114
Fax
(410) 879-7910
NPI assigned
Feb 14, 2013
Last updated
Feb 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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

Authorized official

Name
Mike Cole
Title
VP Insurance Plan Management
Phone
(727) 726-1611

Specialties & licenses 1

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

Addresses

Primary practice location

2003 Rock Spring Rd
Forest Hill, MD 21050-2611

Mailing address

2003 Rock Spring Rd
Forest Hill, MD 21050-2611

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360800000000",
    "number": "1184963977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 ROCK SPRING RD",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 ROCK SPRING RD",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502611",
            "telephone_number": "410-838-1114",
            "fax_number": "410-879-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDOM FOREST HILLS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-14",
        "last_updated": "2013-02-14",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "VP INSURANCE PLAN MANAGEMENT",
        "authorized_official_telephone_number": "727-726-1611"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; 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.