Jonathon Bradley Soward II, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18248 Issued in MD

Practice address

700 Prince Frederick Blvd # MD
Prince Frederick, MD 20678-3141

Phone

(410) 414-8333

NPI assigned

Apr 3, 2023

Last updated

Jul 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tidewater LLC

  • Dentist
  • Prince Frederick, MD
  • NPI 1306359054
  NPD (past)

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1720783533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 PENWICK CIR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217025106",
            "telephone_number": "301-712-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PRINCE FREDERICK BLVD # MD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783141",
            "telephone_number": "410-414-8333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21534 Great Mills Rd",
            "address_purpose": "LOCATION",
            "city": "Lexington Park",
            "state": "MD",
            "postal_code": "206531204",
            "country_code": "US",
            "telephone_number": "301-862-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOWARD",
        "first_name": "JONATHON",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "18248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Maryland Community Network, Inc.
• Southern Maryland Community Network, Inc.
• Southern Maryland Community Network, Inc.
• Southern Maryland Community Network, Inc.
• Southern Maryland Skin Specialists, PC
• Brad Vincent Spagnolo, MD
• Amber L Spradlin, PA-C
• St Paul Place Specialists, Inc.
• Kerri Stallings, CRNP
• Fredrica Stanley

• General Practice Dentistry in Prince Frederick, MD
• Providers in Prince Frederick, 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 Jul 24, 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.