NPIMap

Organization Active NPI

Dentrust Dental Maryland, P.a.

  • General Practice Dentistry
  • Fort George G Meade, MD
National Provider Identifier
1811602907
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTRUST DENTAL MARYLAND, P.A.
Practice address
2799 Rose St BLDG 685
Fort George G Meade, MD 20755-5140
Phone
(267) 927-5000
NPI assigned
Jan 23, 2023
Organization subpart
Yes
Parent organization
DENTRUST DENTAL MARYLAND, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Authorized official

Name
Amanda Anne Clark
Title
Director of Credentaling
Phone
(267) 927-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2799 Rose St BLDG 685
Fort George G Meade, MD 20755-5140

Mailing address

2799 Rose St BLDG 685
Fort George G Meade, MD 20755-5140
Phone (267) 927-5000

Other identifiers 1

IdentifierTypeStateIssuer
10988OtherMDDENTISTRY

Other names 1

  • DOCS Dental Ft. Meade Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ft.meadeinfo@docs.health

National Provider Directory

National Provider Directory
Tax ID family
Dentrust Dental Maryland PA3 organizations share this tax ID, including this one
Part of
Dentrust Dental Maryland PA

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2799 Rose St
Bldg 685
Fort George G Meade, MD 20755

Interoperability endpoints

  • Direct secure messaging: ft.meadeinfo@docs.health

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1811602907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 ROSE ST BLDG 685",
            "city": "FORT GEORGE G MEADE",
            "state": "MD",
            "postal_code": "207555140",
            "telephone_number": "267-927-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 ROSE ST BLDG 685",
            "city": "FORT GEORGE G MEADE",
            "state": "MD",
            "postal_code": "207555140",
            "telephone_number": "267-927-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTRUST DENTAL MARYLAND, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTRUST DENTAL MARYLAND, PA",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTALING",
        "authorized_official_telephone_number": "267-927-5000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTISTRY",
            "identifier": "10988",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ft.meadeinfo@docs.health",
            "affiliation": "N",
            "address_1": "2799 Rose St Bldg 685",
            "city": "Fort George G Meade",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207555140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "DOCS Dental Ft. Meade",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort George G Meade, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.