Family & Aesthetic Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

13169 Issued in MD

Legal business name

FAMILY & AESTHETIC DENTISTRY

Practice address

1003 4TH St
Laurel, MD 20707-3801

Phone

(301) 725-1002

Fax

(301) 725-1150

NPI assigned

Apr 5, 2016

Organization subpart

No

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

Authorized official

Name

Keechun Hong, D.M.D.

Title

Owner

Phone

(301) 725-1002

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1992168082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 4TH ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073801",
            "telephone_number": "301-725-1002",
            "fax_number": "301-725-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 4TH ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073801",
            "telephone_number": "301-725-1002",
            "fax_number": "301-725-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY & AESTHETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "HONG",
        "authorized_official_first_name": "KEECHUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-725-1002",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "13169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Laurel, MD
• Providers in Laurel, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.