NPIMap

Organization Active NPI

Frederick Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • Frederick, MD
National Provider Identifier
1255631370
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
9898 Issued in MD
Legal business name
FREDERICK PEDIATRIC DENTISTRY, LLC
Practice address
77 Thomas Johnson Dr.
Ste. a
Frederick, MD 21702
Phone
(301) 682-3887
Fax
(301) 682-7984
NPI assigned
Oct 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Authorized official

Name
Mrs. Kendall Lee Prichard
Title
Dental Receptionist
Phone
(301) 682-3887

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 9898 MD Primary

Addresses

Primary practice location

77 Thomas Johnson Dr.
Ste. a
Frederick, MD 21702

Mailing address

77 Thomas Johnson Dr.
Ste. a
Frederick, MD 21702
Phone (301) 682-3887

National Provider Directory

National Provider Directory

Locations

77 Thomas Johnson Dr
Ste A
Frederick, MD 21702
Phone (301) 682-3887

NPI Registry JSON

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1255631370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 THOMAS JOHNSON DR.",
            "address_2": "STE. A",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21702",
            "telephone_number": "301-682-3887",
            "fax_number": "301-682-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 THOMAS JOHNSON DR.",
            "address_2": "STE. A",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21702",
            "telephone_number": "301-682-3887",
            "fax_number": "301-682-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "PRICHARD",
        "authorized_official_first_name": "KENDALL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DENTAL RECEPTIONIST",
        "authorized_official_telephone_number": "301-682-3887",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "9898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.