Bethesda TMJ Facial Pain Treatment LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

4590 Issued in MD

Legal business name

BETHESDA TMJ FACIAL PAIN TREATMENT LLC

Practice address

10215 Fernwood Rd
#601
Bethesda, MD 20817

Phone

(301) 897-3350

NPI assigned

Feb 15, 2008

Last updated

Feb 15, 2008By 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

Faith K Anderson

Title

Office Manager

Phone

(301) 897-3350

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1982872644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10215 FERNWOOD ROAD",
            "address_2": "#601",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20817",
            "telephone_number": "301-897-3350",
            "fax_number": "301-897-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 FERNWOOD RD",
            "address_2": "#601",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20817",
            "telephone_number": "301-897-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA TMJ FACIAL PAIN TREATMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "FAITH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "301-897-3350"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MD",
            "license": "4590",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MD",
            "license": "7317",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MD",
            "license": "12705",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Periodontics in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.