Model Dental Clinic

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12619 Issued in MD

Legal business name

MODEL DENTAL CLINIC

Practice address

9520 Berger Rd Ste 105
Columbia, MD 21046-1554

Phone

(410) 730-6666

Fax

(410) 730-3501

NPI assigned

Mar 9, 2007

Last updated

Apr 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roghieh AtapourNPI 1003948704

Title

Owner Dentist

Phone

(410) 730-6666

Specialties & licenses 1

Addresses

Locations

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.

• Roghieh Atapour, DDS

  • General Practice Dentistry
  • Columbia, MD
  • NPI 1003948704
  NPD Authorized official

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1548392152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9520 BERGER RD STE 105",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461554",
            "telephone_number": "410-730-6666",
            "fax_number": "410-730-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 BERGER RD STE 105",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461554",
            "telephone_number": "410-730-6666",
            "fax_number": "410-730-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODEL DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "ATAPOUR",
        "authorized_official_first_name": "ROGHIEH",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "410-730-6666"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "12619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Columbia, MD
• Providers in Columbia, 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 25, 2024; 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.