NPIMap

Organization Active NPI

Fci Dental Care

  • Dentist
  • Joppa, MD
National Provider Identifier
1407388994
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13055 Issued in MD
Legal business name
FCI DENTAL CARE
Practice address
413 Pulaski Hwy Ste 107
Joppa, MD 21085-3626
Phone
(410) 679-4500
Fax
(410) 679-4445
NPI assigned
Apr 3, 2017
Last updated
Nov 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Authorized official

Name
Mr. Mohamed L Saccoh, DDSNPI 1770541971
Title
Dentist/President
Phone
(410) 679-4500

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 13055 MD Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X MD
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

413 Pulaski Hwy Ste 107
Joppa, MD 21085-3626

Mailing address

413 Pulaski Hwy Ste 107
Joppa, MD 21085-3626
Phone (410) 679-4500

National Provider Directory

National Provider Directory

Locations

413 Pulaski Hwy
Ste 107
Joppa, MD 21085
Phone (410) 679-4500

Practitioners & affiliated clinicians

Practitioners 3

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": "1491177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1407388994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 PULASKI HWY STE 107",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210853626",
            "telephone_number": "410-679-4500",
            "fax_number": "410-679-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 PULASKI HWY STE 107",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210853626",
            "telephone_number": "410-679-4500",
            "fax_number": "410-679-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FCI DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-03",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "SACCOH",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "410-679-4500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "13055",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joppa, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.