Magical Smiles Maryland LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

12478 Issued in MD

Legal business name

MAGICAL SMILES MARYLAND LLC

Practice address

230 S Bridge St
Suite a
Elkton, MD 21921-5915

Phone

(410) 398-7711

Fax

(410) 398-7999

NPI assigned

Jun 6, 2016

Organization subpart

No

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

Authorized official

Name

Miss Maria C McClure

Title

Office Manager

Phone

(410) 398-7711

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1982053575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 S BRIDGE ST",
            "address_2": "SUITE A",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215915",
            "telephone_number": "410-398-7711",
            "fax_number": "410-398-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S BRIDGE ST",
            "address_2": "SUITE A",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215915",
            "telephone_number": "410-398-7711",
            "fax_number": "410-398-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGICAL SMILES MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "MCCLURE",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "410-398-7711",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MD",
            "license": "12478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Ann Macdowell, LMSW
• Chrysti S Maculley, ADT
• Rosemary Madl-Young, PHD,
• April C Maenner, LCSW-C
• Joy Ponferrada Magee, FNP- BC
• Jeffrey P Mainolfi, O.D.
• Ashley Denise Maldonado
• Sana N Malik
• Manbir Takhar, P.C.
• Manbir Takhar, P.C.

• Dental Clinic/Center in Elkton, MD
• Providers in Elkton, 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 Jun 6, 2016; 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.