Individual provider Active NPI

Qasiym Gilliam, DDS

  • Dentist
  • Takoma Park, MD
National Provider Identifier
1558780254
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
15394 Issued in MD
Practice address
7511 New Hampshire Ave
Takoma Park, MD 20912-6969
Phone
(301) 431-6883
Fax
(301) 579-0027
NPI assigned
Apr 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15394 MD Primary

Addresses

Primary practice location

7511 New Hampshire Ave
Takoma Park, MD 20912-6969

Mailing address

7511 New Hampshire Ave
Takoma Park, MD 20912-6969
Phone (301) 431-6883

Other practice location 1

11865 Federal Sq Ste 102
Waldorf, MD 20602-3226
Phone (301) 645-2211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15394MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Confident Smiles, LLC CurrentSince May 25, 2025 Accepting new patients
Confident Smiles of Waldorf LLC Current Accepting new patients

Locations

7511 New Hampshire Ave
Takoma Park, MD 20912
Phone (301) 431-6883

11865 Federal Sq
Ste 102
Waldorf, MD 20602
Phone (301) 645-2211

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1558780254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7511 NEW HAMPSHIRE AVE",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209126969",
            "telephone_number": "301-431-6883",
            "fax_number": "301-579-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7511 NEW HAMPSHIRE AVE",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209126969",
            "telephone_number": "301-431-6883",
            "fax_number": "301-579-0027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11865 Federal Sq Ste 102",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206023226",
            "country_code": "US",
            "telephone_number": "301-645-2211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "QASIYM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Takoma Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.