NPIMap

Organization Active NPI

Nova Dental Gaithersburg LLC

  • Dental Clinic/Center
  • Gaithersburg, MD
National Provider Identifier
1992189963
Registry record updated Jul 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
11190 Issued in MD
Legal business name
NOVA DENTAL GAITHERSBURG LLC
Practice address
806 W Diamond Ave Ste 300
Gaithersburg, MD 20878-1415
Phone
(240) 477-8006
Fax
(240) 477-7944
NPI assigned
Jul 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2015

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

Authorized official

Name
Dr. Dmitry Nova, DDS
Title
Owner/Member
Phone
(240) 477-8006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 11190 MD Primary

Addresses

Primary practice location

806 W Diamond Ave Ste 300
Gaithersburg, MD 20878-1415

Mailing address

806 W Diamond Ave Ste 300
Gaithersburg, MD 20878-1415
Phone (240) 477-8006

National Provider Directory

National Provider Directory

Locations

806 W Diamond Ave
Ste 300
Gaithersburg, MD 20878
Phone (240) 477-8006

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1437264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437264000000",
    "number": "1992189963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 W DIAMOND AVE STE 300",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208781415",
            "telephone_number": "240-477-8006",
            "fax_number": "240-477-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 W DIAMOND AVE STE 300",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208781415",
            "telephone_number": "240-477-8006",
            "fax_number": "240-477-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA DENTAL GAITHERSBURG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-19",
        "last_updated": "2015-07-19",
        "status": "A",
        "authorized_official_last_name": "NOVA",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "240-477-8006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MD",
            "license": "11190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2015; 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.