NPIMap

Organization Active NPI

Brite Smile Dental Group, P.C.

  • Dental Clinic/Center
  • Ellicott City, MD
National Provider Identifier
1942634571
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
14679 Issued in MD
Legal business name
BRITE SMILE DENTAL GROUP, P.C.
Practice address
10176 Baltimore National Pike Ste 207
Ellicott City, MD 21042-3652
Phone
(410) 443-5584
NPI assigned
Aug 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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

Authorized official

Name
Jaewon Yoon, DMD
Title
Owner
Phone
(410) 443-5584

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 14679 MD Primary

Addresses

Primary practice location

10176 Baltimore National Pike Ste 207
Ellicott City, MD 21042-3652

Mailing address

10176 Baltimore National Pike Ste 207
Ellicott City, MD 21042-3652
Phone (410) 443-5584

Other identifiers 1

IdentifierTypeStateIssuer
026866600MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Brite Smile Dental Group PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

10176 Baltimore National Pike
Ste 207
Ellicott City, MD 21042
Phone (410) 443-5584

NPI Registry JSON

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377820800000",
    "number": "1942634571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10176 BALTIMORE NATIONAL PIKE STE 207",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423652",
            "telephone_number": "410-443-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10176 BALTIMORE NATIONAL PIKE STE 207",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423652",
            "telephone_number": "410-443-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRITE SMILE DENTAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-30",
        "last_updated": "2013-08-30",
        "status": "A",
        "authorized_official_last_name": "YOON",
        "authorized_official_first_name": "JAEWON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-443-5584",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MD",
            "license": "14679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026866600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.