Michelle Kathryn Papadakis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61088797 Issued in WA

Practice address

47149 Buse Rd BLDG 1370
Patuxent River, MD 20670-1540

Phone

(301) 342-1407

NPI assigned

Jul 30, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1467061978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47149 BUSE RD BLDG 1370",
            "city": "PATUXENT RIVER",
            "state": "MD",
            "postal_code": "206701540",
            "telephone_number": "301-342-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47149 BUSE RD BLDG 1370",
            "city": "PATUXENT RIVER",
            "state": "MD",
            "postal_code": "206701540",
            "telephone_number": "301-342-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPADAKIS",
        "first_name": "MICHELLE",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "TP61089695",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61088797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hoan Boi Nghiem, D.D.S.
• NHC Patuxent River
• Aj Duane Nicholas
• Ejiroghene Onos, MD
• William S Padgett, MD
• Leon Pendergraph Jr., M.D.
• Adam M Preston, OD, PHD
• Valerie J. Riege
• Christopher P. Russell, DPT
• Carl W. Schamu, DMD

• General Practice Dentistry in Patuxent River, MD
• Providers in Patuxent River, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.