NPIMap

Organization Active NPI

Lifetime Dental Care of Maryland, Badger, P.C.

Doing business as Aberdeen Dental Care

  • Dentist
  • Aberdeen, MD
National Provider Identifier
1336518141
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LIFETIME DENTAL CARE OF MARYLAND, BADGER, P.C.
Doing business as
Aberdeen Dental Care
Practice address
1013 Beards Hill Rd
Suite 100
Aberdeen, MD 21001-2293
Phone
(410) 774-5766
NPI assigned
Sep 22, 2015
Last updated
Aug 13, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Authorized official

Name
Brittany Nichelle Howard
Title
Credentialing Affiliation Coordinat
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

1013 Beards Hill Rd
Suite 100
Aberdeen, MD 21001-2293

Mailing address

1200 Network Centre Drive
Suite #2
Effingham, IL 62401
Phone (217) 540-8946

Other names 2

  • Aberdeen Dental Care Doing business as
  • Dental Professionals of Maryland, Gerald Awadzi, PC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Maryland Badger PC16 organizations share this tax ID, including this one
Part of
Dental Professionals of Maryland Badger PC

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

1013 Beards Hill Rd
Ste 100
Aberdeen, MD 21001
Phone (410) 306-6040

NPI Registry JSON

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565654400000",
    "number": "1336518141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NETWORK CENTRE DRIVE",
            "address_2": "SUITE #2",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "62401",
            "telephone_number": "217-540-8946",
            "fax_number": "217-540-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 BEARDS HILL RD",
            "address_2": "SUITE 100",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210012293",
            "telephone_number": "410-774-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME DENTAL CARE OF MARYLAND, BADGER, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, PC",
        "enumeration_date": "2015-09-22",
        "last_updated": "2019-08-13",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "NICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING AFFILIATION COORDINAT",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aberdeen Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aberdeen Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dental Professionals of Maryland, Gerald Awadzi, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Aberdeen, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.