PRP Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PRP DENTAL LLC

Practice address

1522 Pointer Ridge PL Ste E
Bowie, MD 20716-1875

Phone

(301) 249-1102

Fax

(301) 249-3258

NPI assigned

Apr 22, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Shila Yazdani, DDSNPI 1205963527

Title

Ceo

Phone

(202) 669-1572

Specialties & licenses 1

Addresses

Other names 1

• PRP Dental LLC Doing business as

Locations

Practitioners 3

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

• Shila Yazdani, DDS

  • General Practice Dentistry
  • Washington, DC
  • NPI 1205963527
  NPD Authorized official
• Anita May Sung, D.D.S.

  • Dentist
  • Bowie, MD
  • NPI 1598820102
  NPD
• Jennifer Jeanne Castle, D.D.S.

  • Dentist
  • Bowie, MD
  • NPI 1841465952
  NPD (past)

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1497337125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 POINTER RIDGE PL STE E",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161875",
            "telephone_number": "301-249-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 POINTER RIDGE PL STE E",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161875",
            "telephone_number": "301-249-1102",
            "fax_number": "301-249-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRP DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "YAZDANI",
        "authorized_official_first_name": "SHILA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-669-1572",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRP Dental LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Bowie, MD
• Providers in Bowie, 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 22, 2021; 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.