Individual provider Active NPI

Kevin Patrick Dooley, D.D.S.

  • Dentist
  • Burtonsville, MD
National Provider Identifier
1831548908
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
16120 Issued in MD
Practice address
4009 Sandy Spring Rd Ste 201
Burtonsville, MD 20866-1307
Phone
(301) 622-1717
NPI assigned
Jun 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 16120 MD Primary

Addresses

Primary practice location

4009 Sandy Spring Rd Ste 201
Burtonsville, MD 20866-1307

Mailing address

4009 Sandy Spring Rd Ste 201
Burtonsville, MD 20866-1307
Phone (301) 622-1717

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
16120MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Austin D. Drewyer L.L.C. CurrentSince Sep 8, 2025 Accepting new patients

Locations

4009 Sandy Spring Rd
Ste 201
Burtonsville, MD 20866
Phone (301) 622-1717

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": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1831548908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 SANDY SPRING RD STE 201",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661307",
            "telephone_number": "301-622-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 SANDY SPRING RD STE 201",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661307",
            "telephone_number": "301-622-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOLEY",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-08",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "16120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burtonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.