MD Oms SDS, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

MD OMS SDS, LLC

Practice address

5397 Twin Knolls Rd Ste 18
Columbia, MD 21045-3256

Phone

(410) 730-6001

NPI assigned

Nov 1, 2023

Organization subpart

No

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

Authorized official

Name

Charlotte E Vial

Title

Direct of Cred and Prov Rel

Phone

(504) 638-0303

Specialties & licenses 1

Addresses

Tax ID family

MD Oms SDS LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• MD Oms SDS, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Germantown, MD
  • NPI 1083454896
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• MD Oms SDS, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Germantown, MD
  • NPI 1083454896
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mathew K Woodward, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Columbia, MD
  • NPI 1679809958
  NPD
• Kenneth Jingen Wu, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Columbia, MD
  • NPI 1942435961
  NPD (past)

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698796800000",
    "number": "1225801236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091442",
            "telephone_number": "615-678-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5397 TWIN KNOLLS RD STE 18",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453256",
            "telephone_number": "410-730-6001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19717 Executive Park Cir",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "MD",
            "postal_code": "208742639",
            "country_code": "US",
            "telephone_number": "301-916-0486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MD OMS SDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A",
        "authorized_official_last_name": "VIAL",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECT OF CRED AND PROV REL",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• MD Specialty Dental Services, LLC
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• Nathan Mead
• Briana Meader, LCSW-C

• Oral and Maxillofacial Surgery (Dentist) in Columbia, MD
• Providers in Columbia, 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 Nov 1, 2023; 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.