Active NPI
Babak Seihoun
- Dentist
- Waldorf, MD
National Provider Identifier
1871945840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16140
- Practice address
- 12070 Old Line Ctr Ste 101
Waldorf, MD 20602-2503 - Phone
- (413) 221-4979
- NPI assigned
- Jul 1, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401415271 | VA | |
| Dentist | 122300000X | 16140 | MD | Primary |
Addresses
Primary practice location
12070 Old Line Ctr Ste 101
Waldorf, MD 20602-2503
Mailing address
12070 Old Line Ctr Ste 101
Waldorf, MD 20602-2503
Phone (301) 645-8530
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16140 | MD | MD | Dentist |
| 0401415271 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576627200000",
"number": "1871945840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12070 OLD LINE CTR STE 101",
"city": "WALDORF",
"state": "MD",
"postal_code": "206022503",
"telephone_number": "301-645-8530",
"fax_number": "301-843-8570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12070 OLD LINE CTR STE 101",
"city": "WALDORF",
"state": "MD",
"postal_code": "206022503",
"telephone_number": "413-221-4979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEIHOUN",
"first_name": "BABAK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-01",
"last_updated": "2019-12-18",
"certification_date": "2019-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401415271",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "16140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.