Nic Jorge Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

NIC JORGE DENTAL, LLC

Practice address

3290 N Ridge Rd Ste 180
Ellicott City, MD 21043-3656

Phone

(410) 480-9111

NPI assigned

Jun 19, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Nicolas Andrew Jorge, DMDNPI 1356907166

Title

Dentist

Phone

(516) 457-8005

Specialties & licenses 1

Addresses

Other names 1

• Elysian Dental Studio Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicolas Andrew Jorge, DMD

  • General Practice Dentistry
  • Ellicott City, MD
  • NPI 1356907166
  NPD Authorized official
• Chetna Kartik Desai, D.D.S.

  • General Practice Dentistry
  • Ellicott City, MD
  • NPI 1013034891
  NPD (past)

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1821832569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 N RIDGE RD STE 180",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433656",
            "telephone_number": "410-480-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 N RIDGE RD STE 180",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433656",
            "telephone_number": "410-480-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIC JORGE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "JORGE",
        "authorized_official_first_name": "NICOLAS",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "516-457-8005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elysian Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Anne Newkirk, CMT
• Cindy Nguyen, LCSW-C
• Danh Nguyen, APRN
• Emily Nguyen
• Thuy VI Nguyen, MD
• Erika L Nichelson, DO
• Cynthia D Nichols, MS, CCC-SLP
• Samantha Lee Nichols
• Nicole Mason Nutrition, LLC
• Jean-Luc Gaston Niel, DMD

• General Practice Dentistry in Ellicott City, MD
• Providers in Ellicott City, 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 19, 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.