Individual provider Active NPI

Mary Margaret Beattie, DDS

  • General Practice Dentistry
  • Prince Frederick, MD
National Provider Identifier
1235974742
Registry record updated Apr 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18162 Issued in MD
Practice address
284 Merrimac CT
Prince Frederick, MD 20678-4133
Phone
(410) 449-7056
NPI assigned
Jun 26, 2024
Last updated
Apr 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18162 MD Primary

Addresses

Primary practice location

284 Merrimac CT
Prince Frederick, MD 20678-4133

Mailing address

11674 Little Patuxent Pkwy Apt 104
Columbia, MD 21044-4333
Phone (614) 506-8975

Other practice location 1

3130 Olney Sandy Spring Rd
Olney, MD 20832-1408
Phone (240) 665-5485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241001003096 PA Order and Referring Only - DentistPractitioner - Dentist 5496286478

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Olney Modern Dentistry, LLC General Practice CurrentSince Jun 1, 2024 Accepting new patients

Locations

3130 Olney Sandy Spring Rd
Olney, MD 20832
Phone (240) 665-5485

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743897600000",
    "number": "1235974742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11674 LITTLE PATUXENT PKWY APT 104",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210444333",
            "telephone_number": "614-506-8975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 MERRIMAC CT",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784133",
            "telephone_number": "410-449-7056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3130 Olney Sandy Spring Rd",
            "address_purpose": "LOCATION",
            "city": "Olney",
            "state": "MD",
            "postal_code": "208321408",
            "country_code": "US",
            "telephone_number": "240-665-5485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEATTIE",
        "first_name": "MARY",
        "middle_name": "MARGARET",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2025-04-06",
        "certification_date": "2025-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "18162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

Verify at the official NPI Registry.