Individual provider Active NPI

Surina Das

  • Pediatric Dentistry
  • Silver Spring, MD
National Provider Identifier
1649809450
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
17428 Issued in MD
Practice address
12520 Prosperity Dr Ste 300
Silver Spring, MD 20904-1664
Phone
(301) 989-8994
Fax
(410) 651-4256
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 17428 MD Primary
Student in an Organized Health Care Education/Training Program 390200000X LL866 MD

Addresses

Primary practice location

12520 Prosperity Dr Ste 300
Silver Spring, MD 20904-1664

Mailing address

12520 Prosperity Dr Ste 300
Silver Spring, MD 20904-1664
Phone (301) 989-8994

Other identifiers 1

IdentifierTypeStateIssuer
119591300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17428MDMDPediatric Dentist
LL866MDMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Camps Pediatric Dental Center Pediatric Dentistry CurrentSince Dec 10, 2023 Accepting new patients

Locations

12520 Prosperity Dr
Ste 300
Silver Spring, MD 20904
Phone (301) 989-8991

Interoperability endpoints

  • Direct secure messaging: sdas1100431@direct.umm.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1649809450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12520 PROSPERITY DR STE 300",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041664",
            "telephone_number": "301-989-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 PROSPERITY DR STE 300",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041664",
            "telephone_number": "301-989-8994",
            "fax_number": "410-651-4256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAS",
        "first_name": "SURINA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "17428",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": "LL866",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.