NPIMap

Organization Active NPI

Dental Professionals of Maryland, Badger, P.C.

Doing business as Dentistry at Hagerstown

  • General Practice Dentistry
  • Hagerstown, MD
National Provider Identifier
1902571698
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF MARYLAND, BADGER, P.C.
Doing business as
Dentistry at Hagerstown
Practice address
1329 Pennsylvania Ave Ste 201
Hagerstown, MD 21742-3110
Phone
(301) 791-0333
NPI assigned
Aug 13, 2021
Last updated
Nov 10, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF MARYLAND, BADGER, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1329 Pennsylvania Ave Ste 201
Hagerstown, MD 21742-3110

Mailing address

1329 Pennsylvania Ave Ste 201
Hagerstown, MD 21742-3110

Other names 1

  • Dentistry at Hagerstown Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lifetime Dental Care of Maryland Badger PC12 organizations share this tax ID, including this one
Part of
Dental Professionals of Maryland Badger PC

Other organizations with this tax ID 11

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

Locations

1329 Pennsylvania Ave
Ste 201
Hagerstown, MD 21742
Phone (301) 791-0333

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1902571698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 PENNSYLVANIA AVE STE 201",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217423110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 PENNSYLVANIA AVE STE 201",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217423110",
            "telephone_number": "301-791-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF MARYLAND, BADGER, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF MARYLAND, BADGER, P.C.",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentistry at Hagerstown",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dentistry at Hagerstown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.