NPIMap

Organization Active NPI

Stellar Dental Hyattsville, LLC

  • General Practice Dentistry
  • Hyattsville, MD
National Provider Identifier
1730435348
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14124 Issued in MD
Legal business name
STELLAR DENTAL HYATTSVILLE, LLC
Practice address
5813 Eastern Ave
Hyattsville, MD 20782-2201
Phone
(301) 853-1567
NPI assigned
Aug 1, 2012
Organization subpart
Yes
Parent organization
STELLAR DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Authorized official

Name
Dr. Allen Gotora, DDS
Title
Deo
Phone
(301) 853-1567

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 14124 MD Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 14892 MD

Addresses

Primary practice location

5813 Eastern Ave
Hyattsville, MD 20782-2201

Mailing address

5813 Eastern Ave
Hyattsville, MD 20782-2201

National Provider Directory

National Provider Directory
Part of
Stellar Dental LLC

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343779200000",
    "number": "1730435348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5813 EASTERN AVE",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207822201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5813 EASTERN AVE",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207822201",
            "telephone_number": "301-853-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLAR DENTAL HYATTSVILLE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STELLAR DENTAL",
        "enumeration_date": "2012-08-01",
        "last_updated": "2012-08-01",
        "status": "A",
        "authorized_official_last_name": "GOTORA",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "DEO",
        "authorized_official_telephone_number": "301-853-1567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "14124",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "14892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.