Silver Spring Dental Clinic LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12298 Issued in MD

Legal business name

SILVER SPRING DENTAL CLINIC LLC

Practice address

11120 New Hampshire Ave
#301
Silver Spring, MD 20904-2633

Phone

(301) 593-6505

Fax

(301) 593-8237

NPI assigned

Oct 7, 2009

Last updated

May 9, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shin Kim, D.M.D

Title

Dentist

Phone

(301) 593-6505

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1578898680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 NEW HAMPSHIRE AVE",
            "address_2": "#301",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042633",
            "telephone_number": "301-593-6505",
            "fax_number": "301-593-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 NEW HAMPSHIRE AVE",
            "address_2": "#301",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042633",
            "telephone_number": "301-593-6505",
            "fax_number": "301-593-8237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER SPRING DENTAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-07",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SHIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "301-593-6505",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "12298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9199891",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Silver Spring, MD
• Providers in Silver Spring, 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 May 9, 2012; 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.