NPIMap

Organization Active NPI

Derek a Siemon DDS LLC

  • General Practice Dentistry
  • Annapolis, MD
National Provider Identifier
1497825152
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DEREK A SIEMON DDS LLC
Practice address
1833 G Forest Dr
Annapolis, MD 21401
Phone
(410) 263-7338
Fax
(410) 263-7339
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Authorized official

Name
Derek A Siemon, DDSNPI 1700893856
Title
Owner
Phone
(410) 263-7338

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

Addresses

Primary practice location

1833 G Forest Dr
Annapolis, MD 21401

Mailing address

1833 G Forest Dr
Annapolis, MD 21401
Phone (410) 263-7338

National Provider Directory

National Provider Directory

Locations

1833 Forest Dr
Ste G
Annapolis, MD 21401
Phone (410) 263-7338

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426636800000",
    "number": "1497825152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 G FOREST DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "410-263-7338",
            "fax_number": "410-263-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 G FOREST DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "410-263-7338",
            "fax_number": "410-263-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK A SIEMON DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2015-03-18",
        "status": "A",
        "authorized_official_last_name": "SIEMON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-263-7338",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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.