NPIMap

Organization Active NPI

Fusion Dental

  • Dentist
  • Waldorf, MD
National Provider Identifier
1932266335
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FUSION DENTAL
Practice address
2992 Waldorf Marketplace
Waldorf, MD 20603
Phone
(301) 645-1344
Fax
(301) 645-4654
NPI assigned
Jan 3, 2007
Last updated
Aug 10, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
FUSION DENTAL, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Authorized official

Name
Dr. Gregory Richard Bob, DDS
Title
President
Phone
(301) 645-1344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X MD Primary

Addresses

Primary practice location

2992 Waldorf Marketplace
Waldorf, MD 20603

Mailing address

2992 Waldorf Marketplace
Waldorf, MD 20603
Phone (301) 645-1344

National Provider Directory

National Provider Directory
Tax ID family
Greater Maryland Dental Partners-Columbia8 organizations share this tax ID, including this one
Part of
Greater Maryland Dental Partners-Columbia

Other organizations with this tax ID 7

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

Locations

2992 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 645-1344

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1932266335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2992 WALDORF MARKETPLACE",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "20603",
            "telephone_number": "301-645-1344",
            "fax_number": "301-645-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2992 WALDORF MARKETPLACE",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "20603",
            "telephone_number": "301-645-1344",
            "fax_number": "301-645-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUSION DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FUSION DENTAL,  PA",
        "enumeration_date": "2007-01-03",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "BOB",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-645-1344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": null,
            "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 Aug 10, 2015; 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.