Active NPI
Stellar Dental, LLC
- General Practice Dentistry
- Silver Spring, MD
National Provider Identifier
1467018747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- STELLAR DENTAL, LLC
- Practice address
- 11239 Lockwood Dr
Silver Spring, MD 20901-4554 - Phone
- (240) 232-8100
- NPI assigned
- May 13, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Allen Gotora, MD
- Title
- Owner/Doctor
- Phone
- (202) 203-0230
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
11239 Lockwood Dr
Silver Spring, MD 20901-4554
Mailing address
11239 Lockwood Dr
Silver Spring, MD 20901-4554
Phone (240) 232-8100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14124 | Other | MD | LICENSE |
| 199657 | Medicaid | MD |
National Provider Directory
National Provider Directory- Tax ID family
- Stellar Dental LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dentist
- Silver Spring, MD
- NPI 1902202211
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Silver Spring, MD
- NPI 1780831289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557705600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1557705600000",
"number": "1467018747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11239 LOCKWOOD DR",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209014554",
"telephone_number": "240-232-8100",
"fax_number": "240-842-1257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11239 LOCKWOOD DR",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209014554",
"telephone_number": "240-232-8100"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STELLAR DENTAL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-05-13",
"last_updated": "2019-05-13",
"status": "A",
"authorized_official_last_name": "GOTORA",
"authorized_official_first_name": "ALLEN",
"authorized_official_title_or_position": "OWNER/DOCTOR",
"authorized_official_telephone_number": "202-203-0230",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "14124",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "199657",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.