Individual provider Active NPI

Latoya Callahan, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Laurel, MD
National Provider Identifier
1801993530
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
16218 Issued in MD
Practice address
13600 Baltimore Ave Ste 200
Laurel, MD 20707-9495
Phone
(410) 844-3939
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 052600-1 NY
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 16218 MD Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 052600 NY

Addresses

Primary practice location

13600 Baltimore Ave Ste 200
Laurel, MD 20707-9495

Mailing address

9015 Queens Blvd
Apt 2F
Elmhurst, NY 11373-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16218MDMDSocial Worker
052600-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Breezy Hill Ortho Group, LLC Orthodontics and Dentofacial Orthopedics Current Accepting new patients

Locations

3905 National Dr
Ste 340
Burtonsville, MD 20866
Phone (301) 421-1300

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1801993530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9015 QUEENS BLVD",
            "address_2": "APT 2F",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13600 BALTIMORE AVE STE 200",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207079495",
            "telephone_number": "410-844-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "LATOYA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052600-1",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "16218",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "052600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.