Individual provider Active NPI

Patrick B Larosiliere, D.D.S.

  • Dentist
  • District Heights, MD
National Provider Identifier
1255329397
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12811 Issued in MD
Practice address
5805 Silver Hill Rd
# G
District Heights, MD 20747-1168
Phone
(301) 568-8444
Fax
(301) 568-8447
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12811 MD Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 12811 MD

Addresses

Primary practice location

5805 Silver Hill Rd
# G
District Heights, MD 20747-1168

Mailing address

5805 Silver Hill Rd
# G
District Heights, MD 20747-1168
Phone (301) 568-8444

Other identifiers 2

IdentifierTypeStateIssuer
407170100MedicaidMD
401712900MedicaidMD

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
12811MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
National Orthodontic and Pediatric Dentistry Associates Corp Orthodontics and Dentofacial Orthopedics CurrentSince Apr 3, 2022 Accepting new patients
Larosiliere and Associates Dental Care, PA Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Locations

3863 Alabama Ave SE
Washington, DC 20020
Phone (202) 800-4488

Organizations & group practices 2

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1255329397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 SILVER HILL RD",
            "address_2": "# G",
            "city": "DISTRICT HEIGHTS",
            "state": "MD",
            "postal_code": "207471168",
            "telephone_number": "301-568-8444",
            "fax_number": "301-568-8447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5805 SILVER HILL RD",
            "address_2": "# G",
            "city": "DISTRICT HEIGHTS",
            "state": "MD",
            "postal_code": "207471168",
            "telephone_number": "301-568-8444",
            "fax_number": "301-568-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROSILIERE",
        "first_name": "PATRICK",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "12811",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "12811",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407170100",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401712900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in District Heights, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.