Ellicott Dental & Specialty LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ELLICOTT DENTAL & SPECIALTY LLC

Doing business as

BluePointe Dental (Ellicott)

Practice address

9200 Baltimore National Pike Ste E
Ellicott City, MD 21042-2613

Phone

(410) 910-9641

NPI assigned

Apr 11, 2017

Organization subpart

No

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

Authorized official

Name

Bryan Fitzgerald, DDS

Title

Owner

Phone

(410) 910-9641

Specialties & licenses 6

Addresses

Other names 1

• BluePointe Dental (Ellicott) Doing business as

Locations

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1942733423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 VREELAND DR STE 6",
            "city": "SKILLMAN",
            "state": "NJ",
            "postal_code": "085582638",
            "telephone_number": "609-252-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 BALTIMORE NATIONAL PIKE STE E",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422613",
            "telephone_number": "410-910-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLICOTT DENTAL & SPECIALTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-910-9641",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BluePointe Dental (Ellicott)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.