NPIMap

Organization Active NPI

Eldersburg Family Denistry

  • Dentist
  • Eldersburg, MD
National Provider Identifier
1720314206
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9360 Issued in MD
Legal business name
ELDERSBURG FAMILY DENISTRY
Practice address
1510 Liberty Rd
Eldersburg, MD 21784-6511
Phone
(410) 795-2424
NPI assigned
Oct 19, 2009
Last updated
Feb 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Authorized official

Name
Dr. Ronald Davis, D.D.S.NPI 1518186659
Title
Owner
Phone
(410) 795-2424

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 9360 MD Primary

Addresses

Primary practice location

1510 Liberty Rd
Eldersburg, MD 21784-6511

Mailing address

1510 Liberty Rd
Eldersburg, MD 21784-6511
Phone (410) 795-2424

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1255910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1720314206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 LIBERTY RD",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846511",
            "telephone_number": "410-795-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 LIBERTY RD",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846511",
            "telephone_number": "410-795-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERSBURG FAMILY DENISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-19",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-795-2424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "9360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.