NPIMap

Individual provider Active NPI

Danielle Nedwetzky, DMD

  • Dentist
  • Ellicott City, MD
National Provider Identifier
1336643527
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN20663 Issued in MA
Practice address
5424 Meadowpond Dr
Ellicott City, MD 21043-7093
Phone
(301) 693-5704
NPI assigned
Mar 21, 2018
Last updated
Mar 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN20663 MA Primary

Addresses

Primary practice location

5424 Meadowpond Dr
Ellicott City, MD 21043-7093

Mailing address

5424 Meadowpond Dr
Ellicott City, MD 21043-7093
Phone (301) 693-5704

Other names 1

  • Danielle Nedwetzky Rao Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN20663MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1336643527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5424 MEADOWPOND DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210437093",
            "telephone_number": "301-693-5704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 MEADOWPOND DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210437093",
            "telephone_number": "301-693-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEDWETZKY",
        "first_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN20663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "RAO",
            "middle_name": "NEDWETZKY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.