Individual provider Active NPI

Alice Marie Charland Bassford, D.M.D.

  • Dentist
  • Silver Spring, MD
National Provider Identifier
1619943099
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12137 Issued in MD
Practice address
10301 Georgia Ave
Suite # 207
Silver Spring, MD 20902-5020
Phone
(301) 593-5500
Fax
(301) 593-3771
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 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 12137 MD Primary

Addresses

Primary practice location

10301 Georgia Ave
Suite # 207
Silver Spring, MD 20902-5020

Mailing address

10301 Georgia Ave
Suite # 207
Silver Spring, MD 20902-5020
Phone (301) 593-5500

Other names 1

  • Dr. Alice Marie Charland Stutzman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150708001003 DC Order and Referring Only - DentistPractitioner - Dentist 6709085681
O20100930024502 MD DME Supplier - Multi-Specialty - Physician 2062611072 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Silver Spring, MD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12137MDMDDentist

Organizations & group practices 1

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1619943099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10301 GEORGIA AVE",
            "address_2": "SUITE # 207",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209025020",
            "telephone_number": "301-593-5500",
            "fax_number": "301-593-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 GEORGIA AVE",
            "address_2": "SUITE # 207",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209025020",
            "telephone_number": "301-593-5500",
            "fax_number": "301-593-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLAND BASSFORD",
        "first_name": "ALICE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "12137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICE",
            "last_name": "CHARLAND STUTZMAN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.