NPIMap

Organization Active NPI

Georgetowne Park Endodontics

  • Endodontics
  • Rockville, MD
National Provider Identifier
1831758382
Registry record updated Jun 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
GEORGETOWNE PARK ENDODONTICS
Practice address
5846 Hubbard Dr
Rockville, MD 20852-4820
Phone
(301) 822-4132
Fax
(301) 822-4061
NPI assigned
Jun 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2019

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

Authorized official

Name
Dr. Ali Reza Eghtesadi, DDS
Title
Endodontist / Owner
Phone
(301) 822-4132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

5846 Hubbard Dr
Rockville, MD 20852-4820

Mailing address

5846 Hubbard Dr
Rockville, MD 20852-4820
Phone (301) 822-4132

National Provider Directory

National Provider Directory

Locations

5846 Hubbard Dr
Rockville, MD 20852
Phone (301) 822-4132

NPI Registry JSON

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

{
    "created_epoch": "1560038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560038400000",
    "number": "1831758382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5846 HUBBARD DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524820",
            "telephone_number": "301-822-4132",
            "fax_number": "301-822-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5846 HUBBARD DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524820",
            "telephone_number": "301-822-4132",
            "fax_number": "301-822-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWNE PARK ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-09",
        "last_updated": "2019-06-09",
        "status": "A",
        "authorized_official_last_name": "EGHTESADI",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "REZA",
        "authorized_official_title_or_position": "ENDODONTIST / OWNER",
        "authorized_official_telephone_number": "301-822-4132",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2019; 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.