NPIMap

Organization Active NPI

Luxe Dental Care LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Stevensville, MD
National Provider Identifier
1356726301
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
14374 Issued in MD
Legal business name
LUXE DENTAL CARE LLC
Practice address
352 Thompson Creek Mall
Stevensville, MD 21666-2500
Phone
(410) 934-0123
Fax
(410) 934-0124
NPI assigned
Jul 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Authorized official

Name
Aisha Sadaf, DDS
Title
Owner
Phone
(443) 949-2298

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 12683 MD
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 14374 MD Primary

Addresses

Primary practice location

352 Thompson Creek Mall
Stevensville, MD 21666-2500

Mailing address

352 Thompson Creek Mall
Stevensville, MD 21666-2500
Phone (410) 934-0123

Other identifiers 4

IdentifierTypeStateIssuer
071636700MedicaidMD
415749400MedicaidMD
086220700MedicaidMD
058463100MedicaidMD

Other names 1

  • J.A.K. LLC Other name

National Provider Directory

National Provider Directory

Locations

352 Thompson Creek Mall
Stevensville, MD 21666
Phone (410) 934-0123

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1356726301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 THOMPSON CREEK MALL",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216662500",
            "telephone_number": "410-934-0123",
            "fax_number": "410-934-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 THOMPSON CREEK MALL",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216662500",
            "telephone_number": "410-934-0123",
            "fax_number": "410-934-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUXE DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-20",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "SADAF",
        "authorized_official_first_name": "AISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-949-2298",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "12683",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "14374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071636700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "415749400",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "086220700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058463100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J.A.K. LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stevensville, MD

Sources for this page

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