Individual provider Active NPI

Ephraim Lorenzo Altmon, DDS

  • Pediatric Dentistry
  • Temple Hills, MD
National Provider Identifier
1376754424
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DEN1000562 Issued in DC
Practice address
3743 Branch Ave Ste a
Temple Hills, MD 20748-1408
Phone
(240) 606-2699
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 16208 MD
Pediatric Dentistry 1223P0221X DEN1000562 DC Primary

Addresses

Primary practice location

3743 Branch Ave Ste a
Temple Hills, MD 20748-1408

Mailing address

8605 Kittama Dr
Clinton, MD 20735-3179
Phone (240) 606-2699

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
DEN1000562DCMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kiddie Cavity Care CurrentSince Aug 18, 2024 Accepting new patients
Kiddie Cavity Care THMD, LLC Pediatric Dentistry CurrentSince Aug 18, 2024 Accepting new patients
Shiningstars Pediatric Dentistry PC Pediatric Dentistry PastSince Jun 21, 2022 Accepting new patients

Locations

4301 Connecticut Ave NW
Ste 453
Washington, DC 20008
Phone (202) 470-3676

3743 Branch Ave
Ste A
Temple Hills, MD 20748
Phone (240) 606-2699

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1376754424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8605 KITTAMA DR",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353179",
            "telephone_number": "240-606-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3743 BRANCH AVE STE A",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207481408",
            "telephone_number": "240-606-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTMON",
        "first_name": "EPHRAIM",
        "middle_name": "LORENZO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "16208",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "DC",
            "license": "DEN1000562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Hills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.