Paragon Dental, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PARAGON DENTAL, LLC

Practice address

9009 Rhode Island Ave
College Park, MD 20740-1929

Phone

(301) 474-8900

NPI assigned

Jan 9, 2019

Organization subpart

No

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

Authorized official

Name

Yuliya Kupchenko

Title

Manager

Phone

(301) 474-8900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• College Park Dental Associates Doing business as

Locations

Practitioners 1

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

• Charles Richard Drucker, D.D.S.

  • General Practice Dentistry
  • College Park, MD
  • NPI 1669688511
  NPD (past)

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1548733710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9009 RHODE ISLAND AVE",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207401929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9009 RHODE ISLAND AVE",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207401929",
            "telephone_number": "301-474-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARAGON DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "KUPCHENKO",
        "authorized_official_first_name": "YULIYA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "301-474-8900"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111733500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "College Park Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "College Park Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emmanuel Oppong, PHARMD
• Diane Susan Orth, CRNP
• Jennifer Owusu, LMSW
• Pace Consulting, LLC
• Sharon Smallets Palmer, AU.D., CCC-A
• Regina Parquet, ATC
• Shelley Jane Parr, M.D.
• Partners in Abortion Care, LLC
• Prudentia Yeluma Pefok
• Prudentia Yeluma Pefok

• Dental Clinic/Center in College Park, MD
• Providers in College Park, MD by specialty
• Dental Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.