Dental & Prosthodontics Rehab Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

13015 Issued in MD

Legal business name

DENTAL & PROSTHODONTICS REHAB INC.

Doing business as

Waldorf Cosmetic & Implant Dentistry

Practice address

3460 Old Washington Rd
Suite 102
Waldorf, MD 20602-3240

Phone

(301) 638-1420

Fax

(301) 638-1493

NPI assigned

Aug 26, 2011

Last updated

Aug 26, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Radi Masri, D.D.S., M.S., PH.D.

Title

President

Phone

(301) 638-1420

Specialties & licenses 1

Addresses

Other names 1

• Waldorf Cosmetic & Implant Dentistry Doing business as

Locations

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.

• Manisha K Chawla

  • Dentist
  • Waldorf, MD
  • NPI 1790169308
  NPD (past)

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1932489523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 OLD WASHINGTON RD",
            "address_2": "SUITE 102",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023240",
            "telephone_number": "301-638-1420",
            "fax_number": "301-638-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 OLD WASHINGTON RD",
            "address_2": "SUITE 102",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023240",
            "telephone_number": "301-638-1420",
            "fax_number": "301-638-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL & PROSTHODONTICS REHAB INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "MASRI",
        "authorized_official_first_name": "RADI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-638-1420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S., PH.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MD",
            "license": "13015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waldorf Cosmetic & Implant Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marie Grace Del Rosario, CRNP
• William J Delapaz, M.D.
• Sharmane Monique Delgado-Payne, LCSW-C
• Ashley Annetter Dell'Acqua
• Ranier Selorio Delos Reyes
• Dental One Associates Waldorf LLC
• Tadele Worku Desalew, M.D.
• Desicare LLC
• Cherline Dessources
• Devine Grace Behavioral Health Center, LLC

• Dental Clinic/Center in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Dental Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; 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.