Active NPI
Robert Laraway, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Stevensville, MD
National Provider Identifier
1215414917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 16412
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 16412 | MD | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert Laraway DDS | Orthodontics and Dentofacial Orthopedics | Current | Accepting new patients |
Locations
206 Duke St
Stevensville, MD 21666
Phone (410) 855-4430
605 Main St
Ste 100
Stevensville, MD 21666
Interoperability endpoints
- 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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Stevensville, MD
- NPI 1003410143
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.