LIFETIME DENTAL CARE OF MARYLAND, BADGER, P.C. (NPI# 1619032620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619032620 |
| Entity Type | Organization |
| Organization Name | LIFETIME DENTAL CARE OF MARYLAND, BADGER, P.C. |
| Other Organization Name | DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, PC |
| Practice Address |
2191 Defense Hwy #210 Crofton MD 21114 |
| Mailing Address |
1200 Network Centre Drive Suite #2 Effingham IL 62401 |
| Practice Telephone | 4107212610 |
| Practice Fax Number | 4107218053 |
| Mailing Telephone | 2175408946 |
| Mailing Fax Number | 2175408946 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2019-08-13 |
| Authorized Official Name | BRITTANY NICHELLE HOWARD (CREDENTIALING AFFILIATION COORDINAT) |
| Authorized Official Telephone | 2175408946 |
| Is Organization Subpart | Y |
| Parent Organization Name | DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Dental Professionals of Maryland, Gerald Awadzi, PC | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617321 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 151 Bishop Murphy Dr Ste A, Frostburg, MD 21532-1476 | 2020-10-19 |
| 1265959837 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 13919 Baltimore Ave, Laurel, MD 20707-5044 | 2017-08-24 |
| 1265971295 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 821 W Benfield Rd Ste 6, Severna Park, MD 21146-2220 | 2017-02-23 |
| 1659730380 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 6400 Ridge Rd # H, Sykesville, MD 21784-6248 | 2016-02-23 |
| 1144622739 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 703 Baltimore Pike, Bel Air, MD 21014-4209 | 2014-09-25 |
| 1881021855 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 480 Meadow Creek Dr, Ste B, Westminster, MD 21158-4445 | 2013-10-04 |
| 1093140501 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 1200 Network Centre Drive, Suite #2, Effingham, IL 62401 | 2013-09-04 |
| 1972857589 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 7499 Greenbelt Rd, #22, Greenbelt, MD 20770-3402 | 2012-11-05 |
| 1295089001 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 15648 Old Columbia Pike, Burtonsville, MD 20866 | 2012-10-31 |
| 1356365910 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 11301 Rockville Pike, Kensington, MD 20895-1060 | 2006-07-27 |
| Street Address |
2191 DEFENSE HWY #210 |
| City | CROFTON |
| State | MD |
| Zip Code | 21114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740345743 | Craig W Stout | Dentist | 2191 Defense Hwy #210, Crofton, MD 21114 | 2006-12-27 |
| 1639234636 | Roy Kenneth Edelstein | Dentist | 2191 Defense Hwy #210, Crofton, MD 21114 | 2006-12-27 |
| 1245395250 | Richard A Carlson | Dentist | 2191 Defense Hwy #210, Crofton, MD 21114 | 2006-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942857156 | Betty J Wanjau | Occupational Therapy Assistant | 2131 Davidsoville Rd, Crofton, MD 21114 | 2019-08-22 |
| 1972067494 | Brightview Crofton, LLC | Alzheimer Center (Dementia Center) | 1301 Clarity Drive, Crofton, MD 21114 | 2019-01-29 |
| 1225522147 | Jodie Rich | Pharmacist | Shoppers, 1649 Crofton Center, Crofton, MD 21114 | 2018-06-15 |
| 1447769054 | Danielle Ellen Barton | Counselor | 1627 Ardsley Place, Crofton, MD 21114 | 2017-09-26 |
| 1093250474 | Holistic, Re-education, & Empowering Serices, LLC | Community/Behavioral Health | 2305 Fairhaven Lane, Crofton, MD 21114 | 2016-12-21 |
| 1326594201 | Evette Shields | Adult Companion | 1617 Parkridge Circle #152, Crofton, MD 21114 | 2016-08-30 |
| 1861866832 | Kathryn Bucher | Occupational Therapist | 2435 Bolton Lane, Crofton, MD 21114 | 2015-11-13 |
| 1730512062 | James Martin Schwartz | Dentist | 1286 Route 3 North, Crofton, MD 21114 | 2013-08-09 |
| 1184923088 | Jean Louise Dela Torre | Speech-Language Pathologist | 1672 Carlyle Dr. Apt. E, Crofton, MD 21114 | 2011-03-18 |
| 1295033488 | Nancy Fox Royster | Registered Nurse | 1004 Broderick Court, Crofton, MD 21114 | 2011-03-11 |
| Find all providers in zip 21114 | ||||
| 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 |
|---|---|---|---|---|
| 1730512062 | James Martin Schwartz | Dentist | 1286 Route 3 North, Crofton, MD 21114 | 2013-08-09 |
| 1356692024 | Jacob Anthony Nix | Dentist | 1286 State Route 3 S Ste 7, Crofton, MD 21114-1340 | 2012-09-21 |
| 1194867085 | Franklin F Frush | Dentist | 1667 Crofton Ctr Ste 7, Crofton, MD 21114 | 2007-02-14 |
| 1740345743 | Craig W Stout | Dentist | 2191 Defense Hwy #210, Crofton, MD 21114 | 2006-12-27 |
| 1265518617 | Jo Anne M Bernard | Dentist | 2411 Crofton Lane, Suite 6, Crofton, MD 21114 | 2006-10-28 |
| 1124081872 | Ulery Dental and Orthodontics | Dentist | 1286 Maryland Rt 3 S, Crofton, MD 21114-1340 | 2006-04-11 |
| 1497716096 | M. Reza Ghajarnia | Dentist | 1286 Maryland Rt 3 S Ste 7, Crofton, MD 21114-1340 | 2006-03-31 |
| 1154814960 | Charles C Yun | Dentist | 2191 Defense Hwy Ste 210, Crofton, MD 21114-2942 | 2018-06-07 |
| 1801270996 | Koosha Farnoosh | Dentist | 1286 State Route 3 S Ste 7, Crofton, MD 21114-1340 | 2015-07-17 |
| 1225452279 | Gregory Puccio | Dentist | 1286 Maryland Rt 3 S Ste 7, Crofton, MD 21114-1340 | 2014-02-11 |
| Find all providers in CROFTON | ||||
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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.