DR. REGINALD LYNN PETTAWAY (NPI# 1972778207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972778207 |
| Entity Type | Individual |
| Full Name | DR. REGINALD LYNN PETTAWAY |
| Credential | DDS |
| Practice Address |
9850 Key West Ave Suite 308 Rockville MD 20850-3960 |
| Practice Telephone | 3012179700 |
| Practice Fax Number | 3013092554 |
| Mailing Telephone | 3012179700 |
| Mailing Fax Number | 3013092554 |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2008-04-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
10860 | MD | Dental Providers |
| Street Address |
9850 KEY WEST AVE SUITE 308 |
| City | ROCKVILLE |
| State | MD |
| Zip Code | 20850-3960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093714248 | Paul D. Schwartzman, D.m.d, Pa | Clinic/Center | 9850 Key West Ave, Suite 300, Rockville, MD 20850-3960 | 2005-07-19 |
| 1598021859 | Alexandra Spector | Speech-Language Pathologist | 9850 Key West Ave, Suite 200, Rockville, MD 20850-3960 | 2012-04-11 |
| 1083925457 | Rosa Nilo Dastrange | Optometrist | 9850 Key West Ave, Rockville, MD 20850-3960 | 2010-06-30 |
| 1841317849 | Eugene Victor Trembisky | Physical Therapist | 9850 Key West Ave, Suite 120, Rockville, MD 20850-3960 | 2007-03-23 |
| 1215000997 | Children's National Ambulatory Surgery Center | Clinic/Center | 9850 Key West Ave, Rockville, MD 20850-3960 | 2006-11-17 |
| 1326133232 | Jacqueline Calbert | Pediatrics | 9850 Key West Ave, Rockville, MD 20850-3960 | 2006-10-04 |
| 1386699247 | Mallika Umamaheswaran | Pediatrics | 9850 Key West Ave, Suite 312, Rockville, MD 20850-3960 | 2006-05-22 |
| 1063480226 | Greater Washington Orthopaedic Group | Physical Therapist | 9850 Key West Ave, Suite 120, Rockville, MD 20850-3960 | 2006-03-14 |
| 1003883331 | Greater Washington Orthopaedic Group | Orthopaedic Surgery | 9850 Key West Ave, Suite 120, Rockville, MD 20850-3960 | 2006-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487286050 | Um Fdsp Associates, P.a. | Dentist | 9631 Gudelsky Drive, Suite 2135, Rockville, MD 20850 | 2020-02-11 |
| 1134767874 | Bh Brightview Fallsgrove Opco, LLC | Alzheimer Center (Dementia Center) | 9200 Darnestown Road, Rockville, MD 20850 | 2019-12-12 |
| 1750924205 | Omer N Pamuk | Internal Medicine | 9000 Rockville Pike, Building 10, Room 10n-311, Rockville, MD 20850 | 2019-10-28 |
| 1902456502 | Fousseyni M Diawara | Radiologic Technologist | 1680 E Gude Dr Ste 302, Rockville, MD 20850 | 2019-09-16 |
| 1104485697 | Barbara S Delsack | Speech-Language Pathologist | Montgomery County Public Schools, 850 Hungerford Drive, Rockville, MD 20850 | 2019-06-10 |
| 1982178158 | Larissa Woloszyn | Behavioral Analyst | 15425 Shady Grove, Suite 320, Rockville, MD 20850 | 2019-01-21 |
| 1417421843 | Wei Li | Acupuncturist | 9600 Blackwell Road. Suite 300, Rockville, MD 20850 | 2019-01-18 |
| 1881168805 | Heather Jean Scurtu Mann | Psychologist | Quince Orchard Psychotherapy, 9707 Key West Avenue, Suite 100, Rockville, MD 20850 | 2019-01-12 |
| 1295208486 | Laura Hanley | Physical Therapy Assistant | The Village At Rockville, Functional Pathways, 9701 Veirs Drive, Rockville, MD 20850 | 2019-01-10 |
| 1538641964 | Shamire Pierre-louis | Speech-Language Pathologist | 2 Research Place, Rockville, MD 20850 | 2018-09-01 |
| Find all providers in zip 20850 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801376900 | Amelia Berrien Baker | Dentist | 4110 Aspen Hill Rd Ste 310, Rockville, MD 20853-2853 | 2018-08-17 |
| 1265933071 | Oh Cheol Kwon | Dentist | 15200 Shady Grove Rd Ste 105, Rockville, MD 20850-3218 | 2018-02-27 |
| 1104331362 | Susan Sekawaabe Nanyunja | Dentist | 2532 Lindley Ter, Rockville, MD 20850-3032 | 2017-12-11 |
| 1902328222 | Terry Lyles II | Dentist | 192 Halpine Rd Ste A, Rockville, MD 20852-7645 | 2017-07-07 |
| 1669876009 | Michael Brown | Dentist | 14264 Arbor Forest Dr, Rockville, MD 20850-7479 | 2014-10-14 |
| 1093136160 | Potomac Dental Clinic, Inc. | Dentist | 5862 Hubbard Dr, Rockville, MD 20852-4820 | 2013-12-17 |
| 1609209477 | Kathy Dipasquale Kim | Dentist | 15200 Shady Grove Rd Ste 408, Rockville, MD 20850-3218 | 2013-08-15 |
| 1215379995 | Chin-shiu Lin | Dentist | 6225 Executive Blvd, Rockville, MD 20852-3906 | 2013-07-23 |
| 1659614410 | Ghassan Elias Jacklis | Dentist | 11125 Rockville Pike Ste 204, Rockville, MD 20852-3142 | 2013-03-30 |
| 1891072260 | Richard Rehak | Dentist | 306 Prettyman Dr Apt 8201, Rockville, MD 20850-7706 | 2011-11-13 |
| Find all providers in ROCKVILLE | ||||
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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.