FREDERICK PEDIATRIC DENTISTRY, LLC (NPI# 1255631370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255631370 |
| Entity Type | Organization |
| Organization Name | FREDERICK PEDIATRIC DENTISTRY, LLC |
| Practice Address |
77 Thomas Johnson Dr. Ste. A Frederick MD 21702 |
| Practice Telephone | 3016823887 |
| Practice Fax Number | 3016827984 |
| Mailing Telephone | 3016823887 |
| Mailing Fax Number | 3016827984 |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |
| Authorized Official Name | MRS. KENDALL LEE PRICHARD (DENTAL RECEPTIONIST) |
| Authorized Official Telephone | 3016823887 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
9898 | MD | Dental Providers |
| Street Address |
77 THOMAS JOHNSON DR. STE. A |
| City | FREDERICK |
| State | MD |
| Zip Code | 21702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129714 | Rita Akowuah | Nurse Practitioner | 1302 Baker Place East Apt 14, Frederick, MD 21702 | 2020-09-18 |
| 1912416272 | Morgan Nicely | Behavior Technician | 65 Thomas Johnson Drive Suite A, Frederick, MD 21702 | 2017-09-29 |
| 1154840494 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 184 Thomas Johnson Dr Ste 104, Frederick, MD 21702 | 2017-09-19 |
| 1831617471 | Hazel Elizabeth Gill | Physical Therapy Assistant | 2007 Butterfield Overlook, Frederick, MD 21702 | 2017-09-05 |
| 1831610161 | William Haynes | Nurse Practitioner | 103 Water Land Ct., Frederick, MD 21702 | 2017-06-27 |
| 1497299333 | Timothy Stimach | Pharmacist | 1430b W Patrick St, Frederick, MD 21702 | 2016-12-12 |
| 1184167405 | Maryland Nutrition and Diet Services, L.L.C. | Dietitian, Registered | 1301 W. 7th Street, No. 1607, Frederick, MD 21702 | 2016-11-18 |
| 1649649468 | Oluwakemi Olubunmi Osidele | Nurse Practitioner | 188 Thomas Johnson Dr Ste 102, Frederick, MD 21702 | 2015-09-22 |
| 1841678562 | Ventzislava Hristova | Spec/Tech, Pathology | 1050 Boyles St. Building 560 Room 12-39, National Cancer Institute - Frederick, Frederick, MD 21702 | 2015-05-14 |
| 1023404571 | Mychal Lynn Pilia | Advanced Practice Midwife | 7420 Hayward Road, Suite 104, Frederick, MD 21702 | 2015-04-11 |
| Find all providers in zip 21702 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043694623 | Frederick Kidds Pediatric Dentistry LLC | Dentist | 211 Shorebird St Ste B, Frederick, MD 21701-1963 | 2015-07-14 |
| 1295042398 | Joonghyuk Kim | Dentist | 57a Thomas Johnson Drive, Frederick, MD 21702 | 2010-09-10 |
| 1942461181 | Hoa T K Lam | Dentist | 7360 Guilford Drive, Suite #102, Frederick, MD 21704 | 2008-06-20 |
| 1649441494 | Dr.sivakumar Pediatric Dental Center LLC | Dentist | 57a Thomas Johnson Dr, Frederick, MD 21702-4301 | 2008-03-20 |
| 1114094398 | Pediatric Dental Center of Frederick, LLC | Dentist | 7360 Guilford Dr, 102, Frederick, MD 21704-5124 | 2006-11-30 |
| 1164405767 | Thiruvanamalai P Sivakumar | Dentist | 7360 Guildford Drive, Suite 102, Frederick, MD 21704 | 2005-11-28 |
| 1154302313 | Joseph Louis Camacho | Dentist | 77 Thomas Johnson Dr, Suite A, Frederick, MD 21702-4893 | 2005-11-07 |
| 1639554876 | Pediatric Dental Care, LLC | Dentist | 1011 E Patrick St, Frederick, MD 21701-3119 | 2015-07-29 |
| 1316353071 | Robert Hashemi | Dentist | 7360 Guilford Drive, Suite #102, Frederick, MD 21704 | 2014-07-02 |
| 1225163686 | Savithri Sivakumar | Dentist | 350 Montevue Ln, Frederick, MD 21702-8214 | 2007-02-23 |
| Find all providers in FREDERICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.