Signature Dental Center

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SIGNATURE DENTAL CENTER

Practice address

130 Thomas Johnson Dr Ste 1
Frederick, MD 21702-4583

Phone

(240) 831-6789

NPI assigned

Feb 15, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Kiran Nayudu, DDSNPI 1720391030

Title

Owner/Dentist

Phone

(443) 902-1256

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Kiran V Nayudu, DDS

  • Dentist
  • Montgomery Village, MD
  • NPI 1720391030
  NPD Authorized official

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676419200000",
    "number": "1326745845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 THOMAS JOHNSON DR STE 1",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024583",
            "telephone_number": "240-831-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 THOMAS JOHNSON DR STE 1",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024583",
            "telephone_number": "240-831-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A",
        "authorized_official_last_name": "NAYUDU",
        "authorized_official_first_name": "KIRAN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "443-902-1256",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85340200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miranda Shelby Shupp
• Sibte a. Kazmi MD LLC
• Sicard Surgical Solutions
• Harpreet Sidhu
• Virginia Chesson Siemer, CNM
• Silbiotech, Incorporated
• Erica Siler
• Betty Silon, PHD
• Kristin N Silon, M.D.
• Francisco Javier Silva, LGPC

• Dental Clinic/Center in Frederick, MD
• Providers in Frederick, MD by specialty
• Dental Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.