NPIMap

Organization Active NPI

Age One Pediatric Dentistry

  • Pediatric Dentistry
  • Silver Spring, MD
National Provider Identifier
1710438601
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
14126 Issued in MD
Legal business name
AGE ONE PEDIATRIC DENTISTRY
Practice address
8611 2ND Ave
Suite 201
Silver Spring, MD 20910-3372
Phone
(989) 714-4470
NPI assigned
Oct 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Authorized official

Name
Dr. Claudia Williams-Conerly, DENTISTNPI 1851479000
Title
Owner
Phone
(989) 714-4470

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 14126 MD Primary

Addresses

Primary practice location

8611 2ND Ave
Suite 201
Silver Spring, MD 20910-3372

Mailing address

14012 Wagon Way
Silver Spring, MD 20906
Phone (989) 714-4470

National Provider Directory

National Provider Directory
Tax ID family
Age One Pediatric Dentistry2 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.

Locations

8611 2nd Ave
Ste 201
Silver Spring, MD 20910
Phone (301) 359-1188

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": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1710438601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14012 WAGON WAY",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "20906",
            "telephone_number": "989-714-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8611 2ND AVE",
            "address_2": "SUITE 201",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103372",
            "telephone_number": "989-714-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGE ONE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS-CONERLY",
        "authorized_official_first_name": "CLAUDIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-714-4470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DENTIST"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "14126",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 17, 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.