NPIMap

Organization Active NPI

MD-SG Dental, LLC

  • General Practice Dentistry
  • Hagerstown, MD
National Provider Identifier
1285075358
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15311 Issued in MD
Legal business name
MD-SG DENTAL, LLC
Practice address
1730 Massey Blvd Ste 106
Hagerstown, MD 21740-6973
Phone
(866) 273-8204
NPI assigned
Jul 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Authorized official

Name
Shekhar Gupta, DDS
Title
Owner Dentist
Phone
(301) 800-7041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 15311 MD Primary

Addresses

Primary practice location

1730 Massey Blvd Ste 106
Hagerstown, MD 21740-6973

Mailing address

PO Box 3189
Syracuse, NY 13220-3189
Phone (866) 273-8204

Other names 1

  • Aspen Dental Doing business as

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": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1285075358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 MASSEY BLVD STE 106",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406973",
            "telephone_number": "866-273-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD-SG DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-17",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "SHEKHAR",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "301-800-7041",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "15311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.