NPIMap

Organization Active NPI

Marlborough Village Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Upper Marlboro, MD
National Provider Identifier
1720700669
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
MARLBOROUGH VILLAGE ORTHODONTICS
Practice address
5098 Brown Station Road Suite 260
Upper Marlboro, MD 20772
Phone
(240) 326-3738
NPI assigned
Sep 16, 2022
Last updated
Sep 16, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MARLBOROUGH VILLAGE PEDIATRIC DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Authorized official

Name
Dr. Adrian Johnston Wilson, DDSNPI 1518194901
Title
Dentist/Owner
Phone
(443) 280-0968

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU Primary

Addresses

Primary practice location

5098 Brown Station Road Suite 260
Upper Marlboro, MD 20772

Mailing address

14300 Ridge View Lane
Laurel, MD 20707
Phone (443) 280-0968

National Provider Directory

National Provider Directory
Part of
Marlborough Village Pediatric Dental

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1663286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1720700669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 RIDGE VIEW LANE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "443-280-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5098 BROWN STATION ROAD SUITE 260",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "20772",
            "telephone_number": "240-326-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLBOROUGH VILLAGE ORTHODONTICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARLBOROUGH VILLAGE PEDIATRIC DENTAL",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_middle_name": "JOHNSTON",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "443-280-0968",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.