NPIMap

Organization Active NPI

Bright Starr Pediatric Dentistry, LLC

  • Dental Clinic/Center
  • Bowie, MD
National Provider Identifier
1568113082
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BRIGHT STARR PEDIATRIC DENTISTRY, LLC
Practice address
10201 Martin Luther King Jr Hwy Unit 240a
Bowie, MD 20720-4003
Phone
(240) 764-5753
Fax
(240) 764-5799
NPI assigned
Jan 17, 2022
Last updated
Jan 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Authorized official

Name
Dr. Ebonee Monique Thrower, DDSNPI 1710187935
Title
Owner
Phone
(240) 764-5753

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

10201 Martin Luther King Jr Hwy Unit 240a
Bowie, MD 20720-4003

Mailing address

10201 Martin Luther King Jr Hwy Unit 240a
Bowie, MD 20720-4003
Phone (240) 764-5753

Other names 1

  • Bright Starr Pediatric Dentistry, LLC Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL bright.pediatric@gmail.com Direct

National Provider Directory

National Provider Directory

Locations

10201 Martin Luther King Jr Hwy
Unit 240A
Bowie, MD 20720
Phone (240) 764-5753

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1568113082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 MARTIN LUTHER KING JR HWY UNIT 240A",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204003",
            "telephone_number": "240-764-5753",
            "fax_number": "240-764-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 MARTIN LUTHER KING JR HWY UNIT 240A",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204003",
            "telephone_number": "240-764-5753",
            "fax_number": "240-764-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT STARR PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "THROWER",
        "authorized_official_first_name": "EBONEE",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-764-5753",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "bright.pediatric@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10201 Martin Luther King Jr Hwy Unit 240A",
            "city": "Bowie",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207204003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bright Starr Pediatric Dentistry, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.