NPIMap

Organization Active NPI

Riverside Dental at Water'S Edge LLC

  • Dentist
  • Belcamp, MD
National Provider Identifier
1275927089
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D38111 Issued in MD
Legal business name
RIVERSIDE DENTAL AT WATER'S EDGE LLC
Practice address
111 Bata Blvd Ste D
Belcamp, MD 21017-1427
Phone
(410) 272-1535
Fax
(410) 272-0242
NPI assigned
Mar 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Authorized official

Name
Dr. Neelu Milak
Title
Owner
Phone
(410) 272-1535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D38111 MD Primary

Addresses

Primary practice location

111 Bata Blvd Ste D
Belcamp, MD 21017-1427

Mailing address

111 Bata Blvd Ste D
Belcamp, MD 21017-1427
Phone (410) 272-1535

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1275927089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BATA BLVD STE D",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210171427",
            "telephone_number": "410-272-1535",
            "fax_number": "410-272-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BATA BLVD STE D",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210171427",
            "telephone_number": "410-272-1535",
            "fax_number": "410-272-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE DENTAL AT WATER'S EDGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "MILAK",
        "authorized_official_first_name": "NEELU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-272-1535",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "D38111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belcamp, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; 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.