Organization Active NPI

Children'S Choice Pediatric Dentistry

  • Pediatric Dentistry
  • New Carrollton, MD
National Provider Identifier
1508279340
Registry record updated Jun 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
14623 Issued in MD
Legal business name
CHILDREN'S CHOICE PEDIATRIC DENTISTRY
Practice address
8500 Annapolis Rd Ste 213
New Carrollton, MD 20784-3014
Phone
(301) 731-8510
Fax
(888) 390-5037
NPI assigned
Jun 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

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

Authorized official

Name
Dr. Jonelle Senita Grant, DDS,MSPH
Title
Managing Member
Phone
(919) 641-2676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 14623 MD Primary

Addresses

Primary practice location

8500 Annapolis Rd Ste 213
New Carrollton, MD 20784-3014

Mailing address

2821 12TH St NE
Washington, DC 20017-2402
Phone (919) 641-2676

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1508279340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 12TH ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172402",
            "telephone_number": "919-641-2676",
            "fax_number": "888-390-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 ANNAPOLIS RD STE 213",
            "city": "NEW CARROLLTON",
            "state": "MD",
            "postal_code": "207843014",
            "telephone_number": "301-731-8510",
            "fax_number": "888-390-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CHOICE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "JONELLE",
        "authorized_official_middle_name": "SENITA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "919-641-2676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS,MSPH"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "14623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Carrollton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.