NPIMap

Organization Active NPI

Nicole C. Forel DDS, LLC

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1851688816
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13598 Issued in MD
Legal business name
NICOLE C. FOREL DDS, LLC
Doing business as
Light Street Dental
Practice address
600 Light St
Baltimore, MD 21230-3856
Phone
(410) 659-0900
Fax
(410) 659-0902
NPI assigned
Jun 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Authorized official

Name
Dr. Nicole Celeste Forel, DDS
Title
Manager
Phone
(410) 659-0901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 13598 MD Primary

Addresses

Primary practice location

600 Light St
Baltimore, MD 21230-3856

Mailing address

10 W Montgomery St
Baltimore, MD 21230-3806
Phone (410) 783-1340

Other names 1

  • Light Street Dental Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309219200000",
    "number": "1851688816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 W MONTGOMERY ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212303806",
            "telephone_number": "410-783-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 LIGHT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212303856",
            "telephone_number": "410-659-0900",
            "fax_number": "410-659-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE C. FOREL DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A",
        "authorized_official_last_name": "FOREL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "CELESTE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "410-659-0901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Light Street Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; 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.