Maryland General Dentistry LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MARYLAND GENERAL DENTISTRY LLC

Practice address

350 Fortune Ter Ste 101
Rockville, MD 20854-2910

Phone

(301) 279-2600

Fax

(301) 294-6460

NPI assigned

Jul 5, 2023

Organization subpart

No

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

Authorized official

Name

Bradly A GreenNPI 1184287260

Title

Owner

Phone

(301) 279-2600

Specialties & licenses 1

Addresses

Other names 1

• Potomac Woods General Dentistry Doing business as

Practitioners 2

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

• Bradly A Green

  • General Practice Dentistry
  • Rockville, MD
  • NPI 1184287260
  NPD Authorized official
• Robert Raymond Mantoni, D.D.S

  • General Practice Dentistry
  • Silver Spring, MD
  • NPI 1174666838
  NPD

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1902584576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 FORTUNE TER STE 101",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208542910",
            "telephone_number": "301-279-2600",
            "fax_number": "301-294-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 FORTUNE TER STE 101",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208542910",
            "telephone_number": "301-279-2600",
            "fax_number": "301-294-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND GENERAL DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-02-15",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "BRADLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-279-2600"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potomac Woods General Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Maryland CVS Pharmacy, L.L.C.
• Maryland CVS Pharmacy, L.L.C.
• Maryland Dental LLC
• Maryland Eye Physician and Surgeon, LLC
• Maryland Health Operations LLC
• Maryland Inpatient Specialist LLC
• Maryland Integrative Counseling Associates, LLC
• Maryland Medical Group, Inc
• Maryland Medical Specialists Inc

• General Practice Dentistry in Rockville, MD
• Providers in Rockville, 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 5, 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.