Mydntst of Maple Lawn LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MYDNTST OF MAPLE LAWN LLC

Practice address

8175 Westside Blvd Ste a
Fulton, MD 20759-2590

Phone

(443) 756-1011

NPI assigned

Oct 7, 2019

Organization subpart

No

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

Authorized official

Name

Eric Scott Resh, DDS

Title

Owner

Phone

(443) 393-3930

Specialties & licenses 1

Addresses

Other names 1

• Fresh Dental Group Doing business as

Locations

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1760023204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 WESTSIDE BLVD STE A",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592590",
            "telephone_number": "443-756-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 WESTSIDE BLVD STE A",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592590",
            "telephone_number": "443-756-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYDNTST OF MAPLE LAWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-07",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "RESH",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-393-3930",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fresh Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Janell Morton
• Shinel Mullings
• Yannick Mundy
• Reeves Mungyeh
• Danielly Muniz
• Mary Nalepa
• Diana Newman
• Stephane Ngakam
• An Nguyen
• David Ni, MD

• General Practice Dentistry in Fulton, MD
• Providers in Fulton, 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 Oct 7, 2019; 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.