PEDIATRIC DENTAL CARE, LLC (NPI# 1639554876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639554876 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL CARE, LLC |
| Practice Address |
1011 E Patrick St Frederick MD 21701-3119 |
| Practice Telephone | 3013609692 |
| Practice Fax Number | 3016689692 |
| Mailing Telephone | 3013609692 |
| Mailing Fax Number | 3016689692 |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2015-07-29 |
| Authorized Official Name | FARIBA PARYAVI (PEDIATRIC DENTIST) |
| Authorized Official Telephone | 3013609692 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
11552 | MD | Dental Providers |
| Street Address |
1011 E PATRICK ST |
| City | FREDERICK |
| State | MD |
| Zip Code | 21701-3119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730245887 | Kathleen M Lattea | Counselor | 1011 E Patrick St, Frederick, MD 21701-3119 | 2006-12-30 |
| 1447673298 | Sina Behmanesh | Dentist | 1011 E Patrick St, Frederick, MD 21701-3119 | 2014-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670045 | Alana Earp | Social Worker | 810 Toll House Avenue, Frederick, MD 21701 | 2019-10-14 |
| 1851866065 | Main Place Treatment Centers LLC. | Clinic/Center | 127 S. Smallwood Street, Frederick, MD 21701 | 2018-10-04 |
| 1649775933 | Old Fashion Medicine, Inc | Internal Medicine | 95 Gatepost Lane, Apartment 1b, Frederick, MD 21701 | 2018-03-28 |
| 1063917938 | Kristin Deely | Nurse Practitioner | 400 West 7th Street, Cardiac Cath Lab 2nd Floor, Frederick, MD 21701 | 2018-03-24 |
| 1689180119 | Harwood Behavioral Health Partners, LLC | Community/Behavioral Health | 300 B Scholls Lane, Frederick, MD 21701 | 2017-12-20 |
| 1326590068 | Natalie Reid | Nurse Practitioner | 9093 Ridgefield Dr Ste 104, Frederick, MD 21701 | 2016-10-28 |
| 1649727967 | Scl Corpration | In Home Supportive Care | 550 Highland Street, Suite 110, Frederick, MD 21701 | 2016-09-02 |
| 1891159661 | Wellave, LLC | Clinic/Center | 411 Aviation Way Ste 245, Frederick, MD 21701 | 2016-04-07 |
| 1144694969 | Leslee Bry | Counselor | 120 W Church St Ste 3b, Frederick, MD 21701 | 2015-11-17 |
| 1851797732 | Frederick Dental | Dentist | 401 W 7th Street, Frederick Dental, Frederick, MD 21701 | 2014-11-05 |
| Find all providers in zip 21701 | ||||
| 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 |
| 1255631370 | Frederick Pediatric Dentistry, LLC | Dentist | 77 Thomas Johnson Dr., Ste. A, Frederick, MD 21702 | 2010-10-22 |
| 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 |
| 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.