Active NPI
Michael Aregbesola
- Endodontics
- Clinton, MD
National Provider Identifier
1437586138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 15911
- Practice address
- 7905 Malcolm Rd Ste 300
Clinton, MD 20735-1708 - Phone
- (301) 868-5500
- NPI assigned
- Sep 26, 2013
- Last updated
- Jan 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 15911 | MD | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
7905 Malcolm Rd Ste 300
Clinton, MD 20735-1708
Mailing address
7905 Malcolm Rd Ste 300
Clinton, MD 20735-1708
Phone (407) 913-6552
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15911 | MD | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alan J. Goodfriend, DMD, Glenn C. Schermer, DMD, Guido Costa, DMD,P.a. | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Endodontics
- Clinton, MD
- NPI 1447377718
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642118400000",
"number": "1437586138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7905 MALCOLM RD STE 300",
"city": "CLINTON",
"state": "MD",
"postal_code": "207351708",
"telephone_number": "407-913-6552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7905 MALCOLM RD STE 300",
"city": "CLINTON",
"state": "MD",
"postal_code": "207351708",
"telephone_number": "301-868-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AREGBESOLA",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-26",
"last_updated": "2022-01-14",
"certification_date": "2022-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MD",
"license": "15911",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.