NPIMap

Organization Active NPI

Neibauer Dental Care, PC

Doing business as Waldorf Orthodontics

  • General Practice Dentistry
  • White Plains, MD
National Provider Identifier
1629345251
Registry record updated Jul 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NEIBAUER DENTAL CARE, PC
Doing business as
Waldorf Orthodontics
Practice address
10665 Stanhaven PL Ste 105
White Plains, MD 20695-3056
Phone
(301) 632-5480
Fax
(301) 632-6083
NPI assigned
Nov 28, 2011
Last updated
Jul 18, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
NEIBAUER DENTAL CARE, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 18, 2015

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

Authorized official

Name
Kendra Walker
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

10665 Stanhaven PL Ste 105
White Plains, MD 20695-3056

Mailing address

10665 Stanhaven PL Ste 105
White Plains, MD 20695-3056
Phone (301) 632-5480

Other names 1

  • Waldorf Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Neibauer Dental Care PC30 organizations share this tax ID, including this one
Part of
Neibauer Dental Care PC

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Locations

10665 Stanhaven Pl
Ste 105
White Plains, MD 20695
Phone (301) 632-5480

Practitioners & affiliated clinicians

Practitioners 3

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": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437177600000",
    "number": "1629345251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10665 STANHAVEN PL STE 105",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953056",
            "telephone_number": "301-632-5480",
            "fax_number": "301-632-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10665 STANHAVEN PL STE 105",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953056",
            "telephone_number": "301-632-5480",
            "fax_number": "301-632-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIBAUER DENTAL CARE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEIBAUER DENTAL CARE, PC",
        "enumeration_date": "2011-11-28",
        "last_updated": "2015-07-18",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waldorf Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in White Plains, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; 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.