NPIMap

Organization Active NPI

Hill Southern Dental of Maryland PPO PC

  • Dentist
  • Annapolis, MD
National Provider Identifier
1700768546
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
HILL SOUTHERN DENTAL OF MARYLAND PPO PC
Practice address
175 Admiral Cochrane Dr # 10
Annapolis, MD 21401-7316
Phone
(410) 841-5400
NPI assigned
Jul 23, 2025
Organization subpart
Yes
Parent organization
HILL SOUTHERN DENTAL OF MARYLAND PPO PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Authorized official

Name
Erika Melissa Menjivar
Title
Sr. Credentialing Specialist
Phone
(469) 596-6137

Specialties & licenses 1

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

Addresses

Primary practice location

175 Admiral Cochrane Dr # 10
Annapolis, MD 21401-7316

Mailing address

5830 Granite Pkwy Ste 780
Plano, TX 75024-6775

Other names 1

  • Fedra Witting, DDS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hill Southern Dental of Maryland PPO PC9 organizations share this tax ID, including this one
Part of
Hill Southern Dental of Maryland PPO PC

Other organizations with this tax ID 8

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

Locations

175 Admiral Cochrane Dr
#10
Annapolis, MD 21401
Phone (410) 841-5400

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": "1753228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1700768546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 GRANITE PKWY STE 780",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750246775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 ADMIRAL COCHRANE DR # 10",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017316",
            "telephone_number": "410-841-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILL SOUTHERN DENTAL OF MARYLAND PPO PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HILL SOUTHERN DENTAL OF MARYLAND PPO PC",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "MENJIVAR",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_middle_name": "MELISSA",
        "authorized_official_title_or_position": "SR. CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "469-596-6137"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fedra Witting, DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.