Organization Active NPI

Um FDSP Associates, P.a.

  • Dentist
  • Rockville, MD
National Provider Identifier
1487286050
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
UM FDSP ASSOCIATES, P.A.
Practice address
9631 Gudelsky Drive
Suite 2135
Rockville, MD 20850
Phone
(240) 665-6700
Fax
(410) 706-3028
NPI assigned
Feb 11, 2020
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Elyse B Markwitz
Title
Dir. of Medical Credentialing & Qa
Phone
(410) 706-5806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

9631 Gudelsky Drive
Suite 2135
Rockville, MD 20850

Mailing address

650 W Baltimore St RM 5201
Baltimore, MD 21201-1510
Phone (410) 706-5806

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://shadygrove.umd.edu/ U M FDSP Associates PA

National Provider Directory

National Provider Directory
Tax ID family
Um FDSP Associates PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1487286050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 W BALTIMORE ST RM 5201",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011510",
            "telephone_number": "410-706-5806",
            "fax_number": "410-706-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9631 GUDELSKY DRIVE",
            "address_2": "SUITE 2135",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20850",
            "telephone_number": "240-665-6700",
            "fax_number": "410-706-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UM FDSP ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-11",
        "last_updated": "2023-11-27",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "MARKWITZ",
        "authorized_official_first_name": "ELYSE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIR. OF MEDICAL CREDENTIALING & QA",
        "authorized_official_telephone_number": "410-706-5806"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://shadygrove.umd.edu/",
            "affiliation": "Y",
            "affiliationName": "U M FDSP Associates PA",
            "address_1": "9631 Gudelsky Drive",
            "address_2": "Suite 2135",
            "city": "Rockville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.