Active NPI
Shideh Emdadi, D.D.S
- General Practice Dentistry
- Gaithersburg, MD
National Provider Identifier
1346487592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 14134
- Practice address
- 8 Russell Ave
104
Gaithersburg, MD 20877-2966 - Phone
- (301) 869-2500
- Fax
- (301) 926-7655
- NPI assigned
- Jan 9, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 14134 | MD | Primary |
Addresses
Primary practice location
8 Russell Ave
104
Gaithersburg, MD 20877-2966
Mailing address
23116 Timber Creek LN
Clarksburg, MD 20871-4019
Phone (301) 208-1811
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14134 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628121600000",
"number": "1346487592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23116 TIMBER CREEK LN",
"city": "CLARKSBURG",
"state": "MD",
"postal_code": "208714019",
"telephone_number": "301-208-1811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 RUSSELL AVE",
"address_2": "104",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208772966",
"telephone_number": "301-869-2500",
"fax_number": "301-926-7655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMDADI",
"first_name": "SHIDEH",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-09",
"last_updated": "2021-08-05",
"certification_date": "2021-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "14134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.