LUSBY DENTAL LLC (NPI# 1386009405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386009405 |
| Entity Type | Organization |
| Organization Name | LUSBY DENTAL LLC |
| Other Organization Name | TIDEWATER DENTAL LUSBY |
| Practice Address |
10025 Hg Trueman Road Lusby MD 20657 |
| Mailing Address |
10025 Hg Trueman Rd Lusby MD 20657-2868 |
| Practice Telephone | 3018623900 |
| Mailing Telephone | 4103264078 |
| Mailing Fax Number | 4103269311 |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2016-03-10 |
| Authorized Official Name | DR. DAVID JACK COOPER (OWNER) |
| Authorized Official Telephone | 4103264078 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Tidewater Dental Lusby | Doing Business As Name - Organization |
| Street Address |
10025 HG TRUEMAN ROAD |
| City | LUSBY |
| State | MD |
| Zip Code | 20657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790270981 | Weis Markets, Inc. | Pharmacy | 210 H G Trueman Rd., Lusby, MD 20657 | 2018-06-29 |
| 1629592845 | Shannon Crush | Doula | 668 Santa Fe Trl, Lusby, MD 20657 | 2017-07-30 |
| 1497157515 | Amazing Hands Home Care | Home Health | 7810 Kirby Ct, Lusby, MD 20657 | 2014-09-19 |
| 1528381027 | Kristina Sarah Smith | Physical Therapist | 11855 H.g. Trueman Rd, Lusby, MD 20657 | 2010-03-11 |
| 1700067618 | Friendly Pharmacy LLC | Pharmacy | 226 Town Center Dr, Lusby, MD 20657 | 2007-11-19 |
| 1831214089 | Mary F Maxwell | Physical Therapy Assistant | 11855 H G Trueman Rd, Gateau Physical Therapy, Lusby, MD 20657 | 2007-03-20 |
| 1356893069 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 13360 Hg Truman Road, Solomons, MD 20657 | 2016-10-28 |
| 1356466502 | Anita Mccullum | Physical Therapy Assistant | 11855 H G Trueman Rd, Gateau Physical Therapy, Lusby, MD 20657 | 2007-03-20 |
| 1922579010 | Lelia M. Reed | Registered Nurse | 8195 Heron Ln, Lusby, MD 20657-2029 | 2018-12-16 |
| 1922200591 | Christina Dawn Donner | Licensed Practical Nurse | 11940 Six Gun Cir, Lusby, MD 20657-2565 | 2007-06-04 |
| Find all providers in zip 20657 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104903251 | Jack H Ursic | Dentist | 10025 Hg Trueman Rd, Lusby, MD 20657-2861 | 2006-11-01 |
| 1407369143 | Tidewater LLC | Dentist | 10025 Hg Trueman Rd, Lusby, MD 20657-2868 | 2017-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918862 | Munder Omran Ben-omran | Dentist | 18535 Boysenberry Dr Apt 319, Gaithersburg, MD 20879-3690 | 2020-10-05 |
| 1982210423 | Kevin Wang | Dentist | 1057 W Perimeter Rd, Prince County, MD 20762 | 2020-09-21 |
| 1720692262 | Amanda Amaro | Dentist | 9408 Bruce Dr, Silver Spring, MD 20901-4812 | 2020-09-02 |
| 1790396927 | Kyle Westbrook | Dentist | 614 Eastern Shore Dr Ste D, Salisbury, MD 21804-5940 | 2020-08-12 |
| 1235749417 | Hanin Al-rubai | Dentist | 9936 Shelburne Ter Apt 101, Gaithersburg, MD 20878-5351 | 2020-08-03 |
| 1750999736 | Kyung Min Shin | Dentist | 11 S Eutaw St Apt 1609, Baltimore, MD 21201-1638 | 2020-07-16 |
| 1679181846 | Eric J Guida | Dentist | 832 Locust Dr, West River, MD 20778-9745 | 2020-07-14 |
| 1649897935 | Cory Kyser | Dentist | 1900 E Northern Pkwy Ste 103, Baltimore, MD 21239-2109 | 2020-07-02 |
| 1538786181 | Amstrong Njinguet | Dentist | 823 Booker Dr, Capitol Heights, MD 20743-1833 | 2020-06-30 |
| 1063038339 | Patrick Campbell | Dentist | 8300 Wisconsin Ave Apt 511, Bethesda, MD 20814-3194 | 2020-06-22 |
| Find all providers with the same taxonomy | ||||
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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.