Individual provider Active NPI

Floyd Bagwell

  • General Practice Dentistry
  • Forestville, MD
National Provider Identifier
1316095755
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13128 Issued in MD
Practice address
7610 Pennsylvania Ave
302
Forestville, MD 20747-4701
Phone
(301) 568-4800
NPI assigned
Jan 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13128 MD Primary

Addresses

Primary practice location

7610 Pennsylvania Ave
302
Forestville, MD 20747-4701

Mailing address

6613 Allentown Rd
Temple Hills, MD 20748-2723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170403000055 MD Order and Referring Only - DentistPractitioner - Dentist 2062724743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13128MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
S. Kaye Harding, DDS, P.C. General Practice Past Accepting new patients
Floyd Bagwell III, DDS, P.C. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316095755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6613 ALLENTOWN RD",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207482723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7610 PENNSYLVANIA AVE",
            "address_2": "302",
            "city": "FORESTVILLE",
            "state": "MD",
            "postal_code": "207474701",
            "telephone_number": "301-568-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGWELL",
        "first_name": "FLOYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forestville, MD

Sources for this page

Verify at the official NPI Registry.