NPIMap

Organization Active NPI

Cosmetic Smile and Denture Technology Consultants LLC

  • General Practice Dentistry
  • Owings Mills, MD
National Provider Identifier
1396903704
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10848 Issued in MD
Legal business name
COSMETIC SMILE AND DENTURE TECHNOLOGY CONSULTANTS LLC
Practice address
9199 Reisterstown Road
Suite 203a
Owings Mills, MD 21117
Phone
(410) 433-9656
NPI assigned
Jun 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Authorized official

Name
Dr. Roslyn Roxanna Robinson-Kellum, DDS
Title
Owner
Phone
(410) 433-9656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 10848 MD Primary

Addresses

Primary practice location

9199 Reisterstown Road
Suite 203a
Owings Mills, MD 21117

Mailing address

PO Box 39395
Balto, MD 21212-6395
Phone (410) 433-9656

Other identifiers 1

IdentifierTypeStateIssuer
7552840MedicaidMD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1396903704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39395",
            "city": "BALTO",
            "state": "MD",
            "postal_code": "212126395",
            "telephone_number": "410-433-9656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9199 REISTERSTOWN ROAD",
            "address_2": "SUITE 203A",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "21117",
            "telephone_number": "410-433-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSMETIC SMILE AND DENTURE TECHNOLOGY CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "ROBINSON-KELLUM",
        "authorized_official_first_name": "ROSLYN",
        "authorized_official_middle_name": "ROXANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-433-9656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "10848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7552840",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.