Organization Active NPI

Peninsula Dental Care LLC

  • General Practice Dentistry
  • Salisbury, MD
National Provider Identifier
1255069928
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PENINSULA DENTAL CARE LLC
Practice address
302 Kay Ave Ste B
Salisbury, MD 21801-7146
Phone
(410) 543-0599
NPI assigned
Aug 10, 2022
Last updated
Aug 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Authorized official

Name
Dr. Kanwarjit Brar
Title
Owner
Phone
(410) 543-0599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

302 Kay Ave Ste B
Salisbury, MD 21801-7146

Mailing address

302 Kay Ave Ste B
Salisbury, MD 21801-7146

National Provider Directory

National Provider Directory

Locations

302 Kay Ave
Ste B
Salisbury, MD 21801
Phone (410) 543-0599

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1255069928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 KAY AVE STE B",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 KAY AVE STE B",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017146",
            "telephone_number": "410-543-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "BRAR",
        "authorized_official_first_name": "KANWARJIT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-543-0599",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.