NPIMap

Organization Active NPI

Laurel Bush Family Dentistry

  • General Practice Dentistry
  • Bel Air, MD
National Provider Identifier
1326180324
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10773 Issued in MD
Legal business name
LAUREL BUSH FAMILY DENTISTRY
Practice address
2111 Laurel Bush Rd
Ste E
Bel Air, MD 21015
Phone
(443) 512-8703
Fax
(410) 515-1067
NPI assigned
Feb 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Marcia Lynn Koontz
Title
Office Manager
Phone
(443) 512-8703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10773 MD Primary

Addresses

Primary practice location

2111 Laurel Bush Rd
Ste E
Bel Air, MD 21015

Mailing address

2111 Laurel Bush Rd
Ste E
Bel Air, MD 21015
Phone (443) 512-8703

National Provider Directory

National Provider Directory

Locations

2111 Laurel Bush Rd
#E
Bel Air, MD 21015
Phone (443) 512-8703

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326180324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 LAUREL BUSH RD",
            "address_2": "STE E",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "21015",
            "telephone_number": "443-512-8703",
            "fax_number": "410-515-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 LAUREL BUSH RD",
            "address_2": "STE E",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "21015",
            "telephone_number": "443-512-8703",
            "fax_number": "410-515-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL BUSH FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOONTZ",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "443-512-8703",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "10773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.