NPIMap

Organization Active NPI

Endodontics of Gaithersburg, LLC

  • Endodontics
  • Gaithersburg, MD
National Provider Identifier
1568021012
Registry record updated Jun 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
ENDODONTICS OF GAITHERSBURG, LLC
Doing business as
Endodontics of Gaithersburg, LLC
Practice address
847 Quince Orchard Blvd Ste G
Gaithersburg, MD 20878-1677
Phone
(301) 527-0303
Fax
(301) 527-0404
NPI assigned
Jun 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2019

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

Authorized official

Name
Dr. Ali Reza Eghtesadi, DDS
Title
Endodontist/Owner
Phone
(301) 527-0303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

847 Quince Orchard Blvd Ste G
Gaithersburg, MD 20878-1677

Mailing address

847 Quince Orchard Blvd Ste G
Gaithersburg, MD 20878-1677
Phone (301) 527-0303

Other names 1

  • Endodontics of Gaithersburg, LLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1560038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560038400000",
    "number": "1568021012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 QUINCE ORCHARD BLVD STE G",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208781677",
            "telephone_number": "301-527-0303",
            "fax_number": "301-527-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 QUINCE ORCHARD BLVD STE G",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208781677",
            "telephone_number": "301-527-0303",
            "fax_number": "301-527-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTICS OF GAITHERSBURG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-09",
        "last_updated": "2019-06-09",
        "status": "A",
        "authorized_official_last_name": "EGHTESADI",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "REZA",
        "authorized_official_title_or_position": "ENDODONTIST/OWNER",
        "authorized_official_telephone_number": "301-527-0303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endodontics of Gaithersburg, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaithersburg, MD

Sources for this page

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