Individual provider Active NPI

Robert Laraway, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Stevensville, MD
National Provider Identifier
1215414917
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
16412 Issued in MD
Practice address
206 Duke St
Stevensville, MD 21666-4080
Phone
(410) 855-4430
NPI assigned
Jul 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 16412 MD Primary

Addresses

Primary practice location

206 Duke St
Stevensville, MD 21666-4080

Mailing address

206 Duke St
Stevensville, MD 21666-4080
Phone (717) 579-3741

Other practice location 1

808 S 5th Ave
Denton, MD 21629-1398
Phone (410) 479-2650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16412MDMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Laraway DDS Orthodontics and Dentofacial Orthopedics CurrentSince Apr 1, 2021 Accepting new patients

Locations

206 Duke St
Stevensville, MD 21666
Phone (410) 855-4430

605 Main St
Ste 100
Stevensville, MD 21666

Interoperability endpoints

  • Direct secure messaging: robert.laraway.1@20853.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1215414917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 DUKE ST",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216664080",
            "telephone_number": "717-579-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 DUKE ST",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216664080",
            "telephone_number": "410-855-4430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 S 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "MD",
            "postal_code": "216291398",
            "country_code": "US",
            "telephone_number": "410-479-2650",
            "fax_number": "833-916-1012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARAWAY",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-25",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "16412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevensville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.