Oxon Hill Smiles Youth Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

OXON HILL SMILES YOUTH DENTISTRY, PC

Practice address

30 Audrey LN
Suite a
Oxon Hill, MD 20745-1301

Phone

(301) 567-5437

Fax

(301) 567-5456

NPI assigned

Aug 25, 2007

Last updated

Jul 9, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jenell Stump

Title

Manager, Licensing & Credentialing

Phone

(615) 750-0343

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeannette E Suh, DMD

  • General Practice Dentistry
  • Oxon Hill, MD
  • NPI 1023325958
  NPD (past)
• Addisalem Teklu

  • General Practice Dentistry
  • Oxon Hill, MD
  • NPI 1578310371
  NPD (past)

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

{
    "created_epoch": "1188000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404864000000",
    "number": "1861685554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ARCADE UNIT 198747",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191994",
            "telephone_number": "615-750-0343",
            "fax_number": "615-986-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 AUDREY LN",
            "address_2": "SUITE A",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207451301",
            "telephone_number": "301-567-5437",
            "fax_number": "301-567-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OXON HILL SMILES YOUTH DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-25",
        "last_updated": "2014-07-09",
        "status": "A",
        "authorized_official_last_name": "STUMP",
        "authorized_official_first_name": "JENELL",
        "authorized_official_title_or_position": "MANAGER, LICENSING & CREDENTIALING",
        "authorized_official_telephone_number": "615-750-0343",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038809900",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413913500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chinyere Renee Orusakwe, MSOT OTR/L
• Buari Osman, MD
• Tuba Mohammed Oumer
• Oxon Hill Optometry, LLC (My Eye Dr.)
• Oxon Hill Primary Medicine PC
• Oxon Hill Urology Surgery Center PC
• Michael Oyewole, PHARM.D.
• Vabian Lewitt Paden, M.D.
• Sungbum Park, DDS
• Chintan P Patel, MD

• General Practice Dentistry in Oxon Hill, MD
• Providers in Oxon Hill, 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 Jul 9, 2014; 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.