NPIMap

Organization Active NPI

Smile Up Dental Center

  • General Practice Dentistry
  • Glen Burnie, MD
National Provider Identifier
1679920938
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SMILE UP DENTAL CENTER
Practice address
100 Crain Hwy S
Glen Burnie, MD 21061-3528
Phone
(410) 969-9300
Fax
(410) 969-9311
NPI assigned
May 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Authorized official

Name
Nader AfganNPI 1760823892
Title
Owner
Phone
(240) 899-4211

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 DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X MD Primary

Addresses

Primary practice location

100 Crain Hwy S
Glen Burnie, MD 21061-3528

Mailing address

100 Crain Hwy S
Glen Burnie, MD 21061-3528
Phone (410) 969-9300

Other identifiers 1

IdentifierTypeStateIssuer
111047100MedicaidMD

Other names 1

  • Glen Burnie Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

100 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 969-9300

5 Crain Hwy N
Ste 1
Glen Burnie, MD 21061
Phone (410) 969-9300

Practitioners & affiliated clinicians

Practitioners 2

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": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1679920938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CRAIN HWY S",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613528",
            "telephone_number": "410-969-9300",
            "fax_number": "410-969-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CRAIN HWY S",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613528",
            "telephone_number": "410-969-9300",
            "fax_number": "410-969-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE UP DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "AFGAN",
        "authorized_official_first_name": "NADER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-899-4211"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111047100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glen Burnie Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Glen Burnie Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.