GD MD Shady Grove LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GD MD SHADY GROVE LLC

Doing business as

Callahan Dental

Practice address

15225 Shady Grove Rd Ste 301
Rockville, MD 20850-3296

Phone

(301) 948-1212

NPI assigned

May 6, 2024

Organization subpart

No

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

Authorized official

Name

Chad Hendricks

Title

Credentialing

Phone

(612) 859-0444

Specialties & licenses 1

Addresses

Other names 1

• Callahan Dental Doing business as

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1710734710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15225 SHADY GROVE RD STE 301",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503296",
            "telephone_number": "301-948-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15225 SHADY GROVE RD STE 301",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503296",
            "telephone_number": "301-948-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GD MD SHADY GROVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Callahan Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lydehi Tatiana Gbeugbeu Epse Gohore
• Hawanatu Gbla
• Aku Gbon
• Raymond Gbondo
• GD MD Rda LLC (Rockville Dental Arts)
• Ge Orthodontics
• Victoria Geagea, MCMT
• Genevieve Seyram Gebe
• Joseph Gebeily, M.D.
• Julie Gebrael

• General Practice Dentistry in Rockville, MD
• Providers in Rockville, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.