NPIMap

Organization Active NPI

Pristine Smiles LLC

  • General Practice Dentistry
  • Rockville, MD
National Provider Identifier
1548756232
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16623 Issued in MD
Legal business name
PRISTINE SMILES LLC
Practice address
11300 Rockville Pike Ste 1013
Rockville, MD 20852-3039
Phone
(408) 561-3041
NPI assigned
Jul 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Authorized official

Name
Dr. Navneet Dhaliwal, DDSNPI 1790156131
Title
Dentist/Owner
Phone
(408) 561-3041

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 16623 MD Primary
Dental Clinic/Center 261QD0000X 16623 MD

Addresses

Primary practice location

11300 Rockville Pike Ste 1013
Rockville, MD 20852-3039

Mailing address

12620 Greenbriar Rd
Potomac, MD 20854-6330
Phone (408) 561-3041

National Provider Directory

National Provider Directory

Locations

11300 Rockville Pike
Ste 1013
Rockville, MD 20852
Phone (301) 231-9100

Practitioners & affiliated clinicians

Practitioners 3

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": "1530748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1548756232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12620 GREENBRIAR RD",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208546330",
            "telephone_number": "408-561-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 ROCKVILLE PIKE STE 1013",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523039",
            "telephone_number": "408-561-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-05",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "DHALIWAL",
        "authorized_official_first_name": "NAVNEET",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "408-561-3041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "16623",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MD",
            "license": "16623",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.