Michael A King, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

14203 Issued in MD

Practice address

4255 Altamont PL Ste 302
White Plains, MD 20695-3082

Phone

(301) 645-4555

NPI assigned

Mar 30, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 16, 2016 through May 16, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• King Oral Surgery Associates, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • White Plains, MD
  • NPI 1295583011
  NPD Authorized official
• King Oral Surgery Associates LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • White Plains, MD
  • NPI 1316505720
  NPD (past) Authorized official
• Michael a King DDS LLC

  dba King Oral Surgery Group at Camp Springs

  • Oral and Maxillofacial Surgery (Dentist)
  • Camp Springs, MD
  • NPI 1003178963
  NPD (past) Authorized official
• King Oral Surgery Group

  • Oral and Maxillofacial Surgery (Dentist)
  • Waldorf, MD
  • NPI 1679875033
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1194845222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 ALTAMONT PL STE 302",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953082",
            "telephone_number": "615-293-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 ALTAMONT PL STE 302",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953082",
            "telephone_number": "301-645-4555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5801 Allentown Rd Ste 408",
            "address_purpose": "LOCATION",
            "city": "Camp Springs",
            "state": "MD",
            "postal_code": "207464580",
            "country_code": "US",
            "telephone_number": "301-645-4555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-03-05",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "14203",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN012707",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DC",
            "license": "DEN1000656",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028778400",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028778401",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039757600",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 2 NPI",
            "identifier": "1003178963",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kidney Medical Associates Inc
• Kids by the Bay Dental LLC
• Julie Ahyoung Kim, PA-C
• King Oral Surgery Associates LLC
• King Oral Surgery Associates, LLC
• Rebecca A Kinuani, BSN, RN
• Tiffany C. Kirkland
• Deborah M Kitts, RN
• Andrew Kneussle, DPT
• Johnson O Kolawole

• Oral and Maxillofacial Surgery (Dentist) in White Plains, MD
• Providers in White Plains, MD by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.