NPIMap

Organization Active NPI

Woodstock Family Dental LLC

  • Dental Clinic/Center
  • Woodstock, MD
National Provider Identifier
1780411272
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
WOODSTOCK FAMILY DENTAL LLC
Practice address
10741 Birmingham Way
Woodstock, MD 21163-1403
Phone
(410) 750-7855
NPI assigned
Sep 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Dr. Michael Listhaus, DDSNPI 1841814845
Title
President
Phone
(718) 710-6412

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

10741 Birmingham Way
Woodstock, MD 21163-1403

Mailing address

10741 Birmingham Way
Woodstock, MD 21163-1403
Phone (410) 750-7855

National Provider Directory

National Provider Directory

Locations

10741 Birmingham Way
Woodstock, MD 21163
Phone (410) 750-7855

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": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1780411272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10741 BIRMINGHAM WAY",
            "city": "WOODSTOCK",
            "state": "MD",
            "postal_code": "211631403",
            "telephone_number": "410-750-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10741 BIRMINGHAM WAY",
            "city": "WOODSTOCK",
            "state": "MD",
            "postal_code": "211631403",
            "telephone_number": "410-750-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSTOCK FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "LISTHAUS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-710-6412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.