NPIMap

Organization Active NPI

Neibauer Dental Care, PC

Doing business as Neibauer Dental Care. - Waldorf

  • General Practice Dentistry
  • Waldorf, MD
National Provider Identifier
1407123045
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NEIBAUER DENTAL CARE, PC
Doing business as
Neibauer Dental Care. - Waldorf
Practice address
117 Saint Patricks Dr
Waldorf, MD 20603-4574
Phone
(301) 870-4553
Fax
(301) 870-7034
NPI assigned
Nov 28, 2011
Last updated
Nov 28, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
NEIBAUER DENTAL CARE, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Authorized official

Name
Kam Shick
Title
Insurance Coordinator
Phone
(217) 540-5141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

117 Saint Patricks Dr
Waldorf, MD 20603-4574

Mailing address

117 Saint Patricks Dr
Waldorf, MD 20603-4574
Phone (301) 870-4553

Other names 1

  • Neibauer Dental Care. - Waldorf Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Neibauer Dental Care PC30 organizations share this tax ID, including this one
Part of
Neibauer Dental Care PC

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Locations

117 Saint Patricks Dr
Waldorf, MD 20603
Phone (301) 684-6754

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1407123045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 SAINT PATRICKS DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034574",
            "telephone_number": "301-870-4553",
            "fax_number": "301-870-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 SAINT PATRICKS DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034574",
            "telephone_number": "301-870-4553",
            "fax_number": "301-870-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIBAUER DENTAL CARE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEIBAUER DENTAL CARE, PC",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "SHICK",
        "authorized_official_first_name": "KAM",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "217-540-5141"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neibauer Dental Care. - Waldorf",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.