Individual provider Active NPI

Raymond J Mansfield, D.D.S.

  • General Practice Dentistry
  • Germantown, MD
National Provider Identifier
1386647758
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6165 Issued in MD
Practice address
13239 Executive Park Ter
Germantown, MD 20874-2648
Phone
(301) 540-5195
NPI assigned
May 31, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6165 MD Primary

Addresses

Primary practice location

13239 Executive Park Ter
Germantown, MD 20874-2648

Mailing address

13239 Executive Park Ter
Germantown, MD 20874-2648

Other identifiers 1

IdentifierTypeStateIssuer
075154OtherMDTRICARE

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386647758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13239 EXECUTIVE PARK TER",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13239 EXECUTIVE PARK TER",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742648",
            "telephone_number": "301-540-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSFIELD",
        "first_name": "RAYMOND",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "6165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "075154",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.