Individual provider Active NPI

Clifford Nmi Zdanowicz Jr., DDS

  • Dentist
  • Rosedale, MD
National Provider Identifier
1356328967
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13435 Issued in MD
Practice address
9110 Philadelphia Rd Ste 214
Rosedale, MD 21237-4325
Phone
(410) 780-0120
NPI assigned
Dec 23, 2005
Last updated
Mar 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13435 MD Primary

Addresses

Primary practice location

9110 Philadelphia Rd Ste 214
Rosedale, MD 21237-4325

Mailing address

7700 Wisconsin Ave
Bethesda, MD 20814-3578
Phone (301) 656-6800

Other practice location 1

7700 Wisconsin Ave
Bethesda, MD 20814-3578
Phone (301) 656-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Feb 24, 2025 through Feb 24, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13435MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Umar Shahbaz, DMD, LLC CurrentSince Mar 12, 2024 Accepting new patients
Duckett Dental Associates PastSince Mar 12, 2024 Accepting new patients
Karl J. Zeren, D.D.S., LLC Past Accepting new patients

Locations

9110 Philadelphia Rd
Ste 214
Rosedale, MD 21237
Phone (410) 780-0120

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1356328967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143578",
            "telephone_number": "301-656-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9110 PHILADELPHIA RD STE 214",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374325",
            "telephone_number": "410-780-0120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7700 Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208143578",
            "country_code": "US",
            "telephone_number": "301-656-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZDANOWICZ",
        "first_name": "CLIFFORD",
        "middle_name": "NMI",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "13435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

Verify at the official NPI Registry.