NPIMap

Organization Active NPI

Age One Pediatric Dentistry

  • Pediatric Dentistry
  • Silver Spring, MD
National Provider Identifier
1891186664
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
14126 Issued in MD
Legal business name
AGE ONE PEDIATRIC DENTISTRY
Practice address
10313 Georgia Ave Ste 210
Silver Spring, MD 20902-5006
Phone
(301) 565-3536
NPI assigned
Feb 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
Dr. Claudia Williams-Conerly, DDSNPI 1851479000
Title
Owner
Phone
(301) 565-3536

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 14126 MD Primary

Addresses

Primary practice location

10313 Georgia Ave Ste 210
Silver Spring, MD 20902-5006

Mailing address

10313 Georgia Ave Ste 210
Silver Spring, MD 20902-5006
Phone (301) 565-3536

Other identifiers 1

IdentifierTypeStateIssuer
028818700MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Age One Pediatric Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8630 Fenton St
Ste 710
Silver Spring, MD 20910
Phone (301) 589-1044

10313 Georgia Ave
Ste 210
Silver Spring, MD 20902
Phone (301) 565-3536

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": "1423785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1891186664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10313 GEORGIA AVE STE 210",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209025006",
            "telephone_number": "301-565-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10313 GEORGIA AVE STE 210",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209025006",
            "telephone_number": "301-565-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGE ONE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-13",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS-CONERLY",
        "authorized_official_first_name": "CLAUDIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-565-3536",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "14126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028818700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.