Maryland Oral Diagnosis and Therapeutics, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

11508 Issued in MD

Legal business name

MARYLAND ORAL DIAGNOSIS AND THERAPEUTICS, LLC

Doing business as

Maryland Oral Diagnosis and Therapeutics, LLC

Practice address

610 Professional Dr Ste 215
Gaithersburg, MD 20879-3439

Phone

(301) 869-8666

Fax

(301) 869-8677

NPI assigned

Mar 31, 2008

Last updated

Jul 15, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Di Sun, DDS PHDNPI 1851491310

Title

Director

Phone

(301) 869-8666

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• Maryland Oral Diagnosis and Therapeutics, LLC Doing business as
• Oral Pathology Services Other name

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Di Sun, DDS PHD

  • Oral and Maxillofacial Surgery (Dentist)
  • Gaithersburg, MD
  • NPI 1851491310
  NPD Authorized official
• Jinyu Sun, D.D.S

  • Dentist
  • Ellicott City, MD
  • NPI 1730635111
  NPD (past)

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784073600000",
    "number": "1760654784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 PROFESSIONAL DR STE 215",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793439",
            "telephone_number": "301-838-9033",
            "fax_number": "301-838-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 PROFESSIONAL DR STE 215",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793439",
            "telephone_number": "301-869-8666",
            "fax_number": "301-869-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND ORAL DIAGNOSIS AND THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "SUN",
        "authorized_official_first_name": "DI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "301-869-8666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS PHD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "11508",
            "primary": true
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MD",
            "license": "11508",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5486025",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryland Oral Diagnosis and Therapeutics, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oral Pathology Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Oral Pathology Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Phillip Mascendaro
• Niesha Chantee Massey

• Dentist in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.