Rivedale Dental Center LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

RIVEDALE DENTAL CENTER LLC

Practice address

6309 Baltimore Ave Ste 303
Riverdale, MD 20737-1059

Phone

(240) 449-5540

NPI assigned

Dec 11, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Simbarashe Parirenyatwa, DDS

Title

Dentist

Phone

(240) 449-5540

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1780491035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 BALTIMORE AVE STE 303",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371059",
            "telephone_number": "240-449-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 BALTIMORE AVE STE 303",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371059",
            "telephone_number": "240-449-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVEDALE DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "PARIRENYATWA",
        "authorized_official_first_name": "SIMBARASHE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "240-449-5540",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.