NPIMap

Organization Active NPI

Primecaredentalllc

  • Dental Clinic/Center
  • White Marsh, MD
National Provider Identifier
1386100048
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PRIMECAREDENTALLLC
Practice address
11550 Philadelphia Rd Ste 118
White Marsh, MD 21162-1305
Phone
(410) 256-4868
NPI assigned
Feb 18, 2019
Last updated
Feb 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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

Authorized official

Name
Dr. Armin Boutehsaz, DDS
Title
Owner
Phone
(818) 288-0469

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

11550 Philadelphia Rd Ste 118
White Marsh, MD 21162-1305

Mailing address

11550 Philadelphia Rd Ste 118
White Marsh, MD 21162-1305
Phone (410) 256-4868

National Provider Directory

National Provider Directory

Locations

11550 Philadelphia Rd
Ste 118
White Marsh, MD 21162
Phone (410) 256-4868

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": "1550448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550448000000",
    "number": "1386100048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11550 PHILADELPHIA RD STE 118",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211621305",
            "telephone_number": "410-256-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 PHILADELPHIA RD STE 118",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211621305",
            "telephone_number": "410-256-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECAREDENTALLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-18",
        "last_updated": "2019-02-18",
        "status": "A",
        "authorized_official_last_name": "BOUTEHSAZ",
        "authorized_official_first_name": "ARMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-288-0469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Marsh, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.