NPIMap

Organization Active NPI

Dental One Associates Waldorf LLC

  • Dentist
  • Waldorf, MD
National Provider Identifier
1457797151
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DENTAL ONE ASSOCIATES WALDORF LLC
Practice address
3500 Old Washington Rd
301
Waldorf, MD 20602-3224
Phone
(301) 645-4434
NPI assigned
May 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Authorized official

Name
Mike Cole
Title
VP Insurance Plan Management
Phone
(301) 645-4434

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

3500 Old Washington Rd
301
Waldorf, MD 20602-3224

Mailing address

3500 Old Washington Rd
301
Waldorf, MD 20602-3224

National Provider Directory

National Provider Directory

Locations

3500 Old Washington Rd
Ste 301
Waldorf, MD 20602
Phone (301) 645-4434

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369094400000",
    "number": "1457797151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 OLD WASHINGTON RD",
            "address_2": "301",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 OLD WASHINGTON RD",
            "address_2": "301",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023224",
            "telephone_number": "301-645-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ONE ASSOCIATES WALDORF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-05-21",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "VP INSURANCE PLAN MANAGEMENT",
        "authorized_official_telephone_number": "301-645-4434"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 21, 2013; 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.