NPIMap

Organization Active NPI

Forest Hill Family & Cosmetic Dentistry

  • Dentist
  • Forest Hill, MD
National Provider Identifier
1710940911
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
09735 Issued in MD
Legal business name
FOREST HILL FAMILY & COSMETIC DENTISTRY
Practice address
2 Colgate Dr
Suite 101
Forest Hill, MD 21050-2652
Phone
(410) 838-6630
Fax
(410) 838-2616
NPI assigned
Apr 10, 2006
Last updated
Jan 6, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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

Authorized official

Name
Dr. Charles Bryan Ebner, DDSNPI 1841614989
Title
Owner President
Phone
(410) 838-6630

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 09735 MD Primary

Addresses

Primary practice location

2 Colgate Dr
Suite 101
Forest Hill, MD 21050-2652

Mailing address

2 Colgate Dr
Suite 101
Forest Hill, MD 21050-2652
Phone (410) 838-6630

National Provider Directory

National Provider Directory

Locations

2 Colgate Dr
Ste 101
Forest Hill, MD 21050
Phone (410) 838-6630

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388966400000",
    "number": "1710940911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COLGATE DR",
            "address_2": "SUITE 101",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502652",
            "telephone_number": "410-838-6630",
            "fax_number": "410-838-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COLGATE DR",
            "address_2": "SUITE 101",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502652",
            "telephone_number": "410-838-6630",
            "fax_number": "410-838-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST HILL FAMILY & COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2014-01-06",
        "status": "A",
        "authorized_official_last_name": "EBNER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER  PRESIDENT",
        "authorized_official_telephone_number": "410-838-6630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "09735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; 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.