Wheaton Mall Dental LLP

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WHEATON MALL DENTAL LLP

Practice address

11160 Veirs Mill Rd SPC 168
Wheaton, MD 20902-5913

Phone

(410) 933-9300

NPI assigned

Jun 24, 2014

Last updated

Jun 24, 2014By 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. Rostislav Krasnov, DDS

Title

Dentist

Phone

(410) 933-9300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403568000000",
    "number": "1770998247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160 VEIRS MILL RD SPC 168",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209025913",
            "telephone_number": "410-933-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 VEIRS MILL RD SPC 168",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209025913",
            "telephone_number": "410-933-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHEATON MALL DENTAL LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A",
        "authorized_official_last_name": "KRASNOV",
        "authorized_official_first_name": "ROSTISLAV",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "410-933-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Weeks Mills
• Anne Sophia Wellington Goldsmith, PT
• Wheaton Chiropractic LLC
• Wheaton Dental Center
• Wheaton Dental Center
• Wheaton Operator LLC (Montcare Wheaton)
• Wheaton Operator LLC
• Martha V White, M.D.
• Daniela Wiggins, MD
• Antonio Twane Williams, MS

• General Practice Dentistry in Wheaton, MD
• Providers in Wheaton, 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 Jun 24, 2014; 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.