Organization Active NPI

DRS Mintz & Abbott LLC

  • Orofacial Pain Dentistry
  • Rockville, MD
National Provider Identifier
1386142123
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
Legal business name
DRS MINTZ & ABBOTT LLC
Practice address
6010 Executive Blvd Ste 500
Rockville, MD 20852-3827
Phone
(301) 530-8570
Fax
(301) 530-8572
NPI assigned
Jan 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Jeremy James AbbottNPI 1891857074
Title
Dentist/Owner
Phone
(805) 559-0579

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X
Orofacial Pain DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X2210X Primary

Addresses

Primary practice location

6010 Executive Blvd Ste 500
Rockville, MD 20852-3827

Mailing address

6010 Executive Blvd Ste 500
Rockville, MD 20852-3827
Phone (301) 530-8570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180305001401 DC Part B Supplier - Clinic/Group Practice 9335400548 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville, MD
O20180420000994 MD DME Supplier - Oral Surgery - Dentist 9335400548 Practice locations: Rockville, MD

National Provider Directory

National Provider Directory

Locations

10401 Old Georgetown Rd
Ste 106
Bethesda, MD 20814
Phone (301) 530-8570

6010 Executive Blvd
Ste 500
Rockville, MD 20852
Phone (301) 530-8570

Practitioners & affiliated clinicians

Practitioners 1

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": "1516924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1386142123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 EXECUTIVE BLVD STE 500",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523827",
            "telephone_number": "301-530-8570",
            "fax_number": "301-530-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 EXECUTIVE BLVD STE 500",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523827",
            "telephone_number": "301-530-8570",
            "fax_number": "301-530-8572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS MINTZ & ABBOTT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-26",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "805-559-0579"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orofacial Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.