NPIMap

Organization Active NPI

Greater Baden Medical Service Incorporated

  • General Practice Dentistry
  • Capitol Heights, MD
National Provider Identifier
1477073773
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GREATER BADEN MEDICAL SERVICE INCORPORATED
Practice address
1458 Addison Rd S
Capitol Heights, MD 20743-4413
Phone
(301) 888-2233
NPI assigned
Jun 27, 2017
Organization subpart
Yes
Parent organization
GREATER BADEN MEDICAL SERVICES INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Authorized official

Name
Jeffrey A Kurcab
Title
Cfo
Phone
(301) 599-2172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1458 Addison Rd S
Capitol Heights, MD 20743-4413

Mailing address

7450 Albert Rd FL 3
Brandywine, MD 20613-3035
Phone (301) 888-2233

Other identifiers 1

IdentifierTypeStateIssuer
299004100MedicaidMD

Other names 1

  • Greater Baden Medical Service at Capitol Heights I - Dental Other name

National Provider Directory

National Provider Directory
Tax ID family
Greater Baden Med SVC I15 organizations share this tax ID, including this one
Part of
Greater Baden Med SVC I

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

1458 Addison Rd S
Capitol Heights, MD 20743
Phone (301) 324-1500

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1477073773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 ALBERT RD FL 3",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133035",
            "telephone_number": "301-888-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1458 ADDISON RD S",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207434413",
            "telephone_number": "301-888-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER BADEN MEDICAL SERVICE INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREATER BADEN MEDICAL SERVICES INCORPORATED",
        "enumeration_date": "2017-06-27",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "KURCAB",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-599-2172"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299004100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Baden Medical Service at Capitol Heights I - Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Capitol Heights, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.