Smile Loft Glen Burnie LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SMILE LOFT GLEN BURNIE LLC

Practice address

325 Hospital Dr Ste 101
Glen Burnie, MD 21061-5806

Phone

(410) 768-4488

NPI assigned

Aug 3, 2020

Organization subpart

No

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

Authorized official

Name

Christine Rai

Title

Director of HR

Phone

(410) 610-3071

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

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

• Kenneth Leong, DDS

  • Dentist
  • Glen Burnie, MD
  • NPI 1669257523
  NPD
• Grace A Altmann, DMD

  • General Practice Dentistry
  • Glen Burnie, MD
  • NPI 1407935711
  NPD (past)
• Vanessa Sciortino, D.D.S.

  • General Practice Dentistry
  • Glen Burnie, MD
  • NPI 1942329677
  NPD (past)

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1568072825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 HOSPITAL DR STE 101",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615806",
            "telephone_number": "410-768-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 HOSPITAL DR STE 101",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615806",
            "telephone_number": "410-768-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE LOFT GLEN BURNIE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "RAI",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "DIRECTOR OF HR",
        "authorized_official_telephone_number": "410-610-3071"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046068200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057073700",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Anne Slear, PHARMD
• Sleep Disorders CTRS of the Mid Atlantic LLC
• Sleep Services of America, Inc
• Stephanie D Smack, LCSW-C
• Nicole Small, CRNP
• Smile Up Dental Center
• Dominique Nicole Smith-Hicks
• Ann Virginia Smith, LCSW-C
• Cemia Smith, LMSW
• Christopher David Smith

• General Practice Dentistry in Glen Burnie, MD
• Providers in Glen Burnie, 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 Aug 3, 2020; 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.