NPIMap

Organization Active NPI

Dental Professionals of Maryland, Badger, P.C.

Doing business as Loch Ridge Dental Care

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1366795312
Registry record updated Nov 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF MARYLAND, BADGER, P.C.
Doing business as
Loch Ridge Dental Care
Practice address
1708 Joan Ave
Baltimore, MD 21234-3717
Phone
(410) 668-7171
Fax
(410) 668-7172
NPI assigned
Oct 16, 2012
Last updated
Nov 6, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
HEARTLAND DENTLA CARE OF MARYLANDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 6, 2021

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

Authorized official

Name
Marie Kuhl
Title
Credentialing Manager
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

1708 Joan Ave
Baltimore, MD 21234-3717

Mailing address

1708 Joan Ave
Baltimore, MD 21234-3717
Phone (410) 668-7171

Other names 1

  • Loch Ridge Dental Care Doing business as

National Provider Directory

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

Other organizations with this tax ID 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636156800000",
    "number": "1366795312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 JOAN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212343717",
            "telephone_number": "410-668-7171",
            "fax_number": "410-668-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 JOAN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212343717",
            "telephone_number": "410-668-7171",
            "fax_number": "410-668-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF MARYLAND, BADGER, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND DENTLA CARE OF MARYLAND",
        "enumeration_date": "2012-10-16",
        "last_updated": "2021-11-06",
        "certification_date": "2021-11-06",
        "status": "A",
        "authorized_official_last_name": "KUHL",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loch Ridge Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Loch Ridge Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.

Verify at the official NPI Registry.