NPIMap

Organization Active NPI

Tiny Tooth Pediatric Dentistry

  • Pediatric Dentistry
  • Columbia, MD
National Provider Identifier
1861077208
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
TINY TOOTH PEDIATRIC DENTISTRY
Practice address
8808 Centre Park Dr Ste 303
Columbia, MD 21045-2224
Phone
(443) 812-8027
NPI assigned
Mar 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Authorized official

Name
Dr. Su Kim, DDSNPI 1093169344
Title
Pediatric Dentist
Phone
(443) 812-8027

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

8808 Centre Park Dr Ste 303
Columbia, MD 21045-2224

Mailing address

8032 Trotters Chase
Ellicott City, MD 21043-7592
Phone (443) 812-8027

National Provider Directory

National Provider Directory

Locations

8808 Centre Park Dr
Ste 303
Columbia, MD 21045
Phone (443) 812-8027

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1861077208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8032 TROTTERS CHASE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210437592",
            "telephone_number": "443-812-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8808 CENTRE PARK DR STE 303",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452224",
            "telephone_number": "443-812-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TINY TOOTH PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SU",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "443-812-8027",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.