NPIMap

Organization Active NPI

Pak Dental Associates, PC

Doing business as Elite Family Dental

  • General Practice Dentistry
  • Ellicott City, MD
National Provider Identifier
1629127386
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12581 Issued in MD
Legal business name
PAK DENTAL ASSOCIATES, PC
Doing business as
Elite Family Dental
Practice address
10326 Baltimore National Pike
Suite a
Ellicott City, MD 21042-2128
Phone
(410) 461-1166
Fax
(410) 461-1470
NPI assigned
Jan 10, 2007
Last updated
Oct 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Authorized official

Name
Dr. Frances Pak, D.M.D.NPI 1932170685
Title
President
Phone
(410) 461-1166

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
General Practice Dentistry 1223G0001X 12581 MD Primary

Addresses

Primary practice location

10326 Baltimore National Pike
Suite a
Ellicott City, MD 21042-2128

Mailing address

10326 Baltimore National Pike
Suite a
Ellicott City, MD 21042-2128
Phone (410) 461-1166

Other identifiers 1

IdentifierTypeStateIssuer
365500800MedicaidMD

Other names 1

  • Elite Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

10326 Baltimore National Pike
#A
Ellicott City, MD 21042
Phone (410) 461-1166

Practitioners & affiliated clinicians

Practitioners 1

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": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1629127386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10326 BALTIMORE NATIONAL PIKE",
            "address_2": "SUITE A",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422128",
            "telephone_number": "410-461-1166",
            "fax_number": "410-461-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10326 BALTIMORE NATIONAL PIKE",
            "address_2": "SUITE A",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422128",
            "telephone_number": "410-461-1166",
            "fax_number": "410-461-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAK DENTAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "PAK",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-461-1166",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "12581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "365500800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; 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.