NPIMap

Organization Active NPI

Chevy Chase Implant & Oral Surgery. L.L.C.

  • Oral and Maxillofacial Surgery Clinic/Center
  • Chevy Chase, MD
National Provider Identifier
1518329614
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
16129 Issued in MD
Legal business name
CHEVY CHASE IMPLANT & ORAL SURGERY. L.L.C.
Practice address
5550 Friendship Blvd Ste 250
Chevy Chase, MD 20815-7296
Phone
(301) 652-8555
Fax
(301) 215-7578
NPI assigned
Mar 28, 2016
Last updated
Mar 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Authorized official

Name
Charlie Park, D.D.S.NPI 1598932212
Title
President
Phone
(301) 525-9398

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
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 16129 MD Primary

Addresses

Primary practice location

5550 Friendship Blvd Ste 250
Chevy Chase, MD 20815-7296

Mailing address

5550 Friendship Blvd Ste 250
Chevy Chase, MD 20815-7296
Phone (301) 652-8555

National Provider Directory

National Provider Directory

Locations

5550 Friendship Blvd
Ste 250
Chevy Chase, MD 20815
Phone (301) 652-8555

Practitioners & affiliated clinicians

Practitioners 4

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": "1459123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459123200000",
    "number": "1518329614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 FRIENDSHIP BLVD STE 250",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208157296",
            "telephone_number": "301-652-8555",
            "fax_number": "301-215-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 FRIENDSHIP BLVD STE 250",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208157296",
            "telephone_number": "301-652-8555",
            "fax_number": "301-215-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEVY CHASE IMPLANT & ORAL SURGERY. L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-28",
        "last_updated": "2016-03-28",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CHARLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-525-9398",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "16129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.