NPIMap

Organization Active NPI

Hagertown Dental Center

  • Dentist
  • Hagerstown, MD
National Provider Identifier
1538398797
Registry record updated Jul 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13215 Issued in MD
Legal business name
HAGERTOWN DENTAL CENTER
Practice address
301 E Antietam St
Hagerstown, MD 21740-2608
Phone
(301) 733-2861
Fax
(301) 733-7557
NPI assigned
Jul 9, 2009
Last updated
Jul 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2009

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

Authorized official

Name
Dr. Vic A Choudry, DDS
Title
Dentist
Phone
(301) 733-2861

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3459 MD
Dentist 122300000X 6844 MD
Dentist 122300000X 13215 MD Primary

Addresses

Primary practice location

301 E Antietam St
Hagerstown, MD 21740-2608

Mailing address

301 E Antietam St
Hagerstown, MD 21740-2608
Phone (301) 733-2861

Other identifiers 1

IdentifierTypeStateIssuer
019747500MedicaidMD

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, 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": "1247097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247097600000",
    "number": "1538398797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E ANTIETAM ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217402608",
            "telephone_number": "301-733-2861",
            "fax_number": "301-733-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E ANTIETAM ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217402608",
            "telephone_number": "301-733-2861",
            "fax_number": "301-733-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGERTOWN DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-09",
        "last_updated": "2009-07-09",
        "status": "A",
        "authorized_official_last_name": "CHOUDRY",
        "authorized_official_first_name": "VIC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "301-733-2861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "3459",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "6844",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "13215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019747500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.