NPIMap

Organization Active NPI

Quality Dental LLC

  • Dentist
  • Bowie, MD
National Provider Identifier
1679089619
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14280 Issued in MD
Legal business name
QUALITY DENTAL LLC
Practice address
15511 Annapolis Rd Ste 540
Bowie, MD 20715-3014
Phone
(301) 744-8123
NPI assigned
Dec 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Authorized official

Name
Dr. Phillip Sidney Martin, DDSNPI 1871745307
Title
President
Phone
(301) 200-8484

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 14280 MD Primary

Addresses

Primary practice location

15511 Annapolis Rd Ste 540
Bowie, MD 20715-3014

Mailing address

15511 Annapolis Rd Ste 540
Bowie, MD 20715-3014
Phone (301) 744-8123

Other identifiers 1

IdentifierTypeStateIssuer
040333300MedicaidDC

National Provider Directory

National Provider Directory

Locations

15511 Annapolis Rd
Ste 540
Bowie, MD 20715
Phone (301) 200-8484

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594080000000",
    "number": "1679089619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15511 ANNAPOLIS RD STE 540",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207153014",
            "telephone_number": "301-744-8123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15511 ANNAPOLIS RD STE 540",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207153014",
            "telephone_number": "301-744-8123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-28",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "SIDNEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-200-8484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "14280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040333300",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.