NPIMap

Organization Active NPI

Super Smile Center of Bethesda

  • Dentist
  • Bethesda, MD
National Provider Identifier
1669824082
Registry record updated Jul 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13054 Issued in MD
Legal business name
SUPER SMILE CENTER OF BETHESDA
Practice address
10320 Westlake Dr
109
Bethesda, MD 20817-6448
Phone
(301) 469-4775
Fax
(301) 469-4776
NPI assigned
Jul 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2016

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

Authorized official

Name
Dr. Amisha N Shroff
Title
Owner / Dentist
Phone
(301) 469-4775

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 13054 MD Primary

Addresses

Primary practice location

10320 Westlake Dr
109
Bethesda, MD 20817-6448

Mailing address

10320 Westlake Dr
109
Bethesda, MD 20817-6448
Phone (301) 469-4775

National Provider Directory

National Provider Directory
Tax ID family
Super Smile Center of Bethesda2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1468022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468022400000",
    "number": "1669824082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10320 WESTLAKE DR",
            "address_2": "109",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208176448",
            "telephone_number": "301-469-4775",
            "fax_number": "301-469-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 WESTLAKE DR",
            "address_2": "109",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208176448",
            "telephone_number": "301-469-4775",
            "fax_number": "301-469-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER SMILE CENTER OF BETHESDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-09",
        "last_updated": "2016-07-09",
        "status": "A",
        "authorized_official_last_name": "SHROFF",
        "authorized_official_first_name": "AMISHA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER / DENTIST",
        "authorized_official_telephone_number": "301-469-4775",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "13054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2016; 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.