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ORAL PATHOLOGY SERVICES/MARYLAND ORAL DIAGNOSIS AND THERAPEUTICS LLC NPI 1760654784


NPI Information

NPI: 1760654784
Provider Name: ORAL PATHOLOGY SERVICES/MARYLAND ORAL DIAGNOSIS AND THERAPEUTICS, LLC

Other Name: ORAL PATHOLOGY SERVICES

Classification: Dentist - 1223P0106X
Entity Type: Organization

Specialization: Oral and Maxillofacial Pathology

CLIA Number: 21D0941021

Address:
610 PROFESSIONAL DR STE 215
GAITHERSBURG, MD
ZIP 20879
Phone: (301) 869-8666
Get Directions

ORAL PATHOLOGY SERVICES/MARYLAND ORAL DIAGNOSIS AND THERAPEUTICS, LLC is an oral and maxillofacial pathology dentist in Gaithersburg, MD. The provider is the specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. ORAL PATHOLOGY SERVICES/MARYLAND ORAL DIAGNOSIS AND THERAPEUTICS, LLC NPI is 1760654784. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Oral Pathology Services.

The provider's business location address is:

610 PROFESSIONAL DR STE 215
GAITHERSBURG, MD
ZIP 20879-439
Phone: (301) 869-8666
Fax: (301) 869-8677

The provider's authorized official is Di Sun .
The authorized official title is Director and has the following contact phone number (301) 869-8666.

The CLIA number assigned to this NPI record is 21D0941021 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/31/2008 and was last updated on 4/3/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentist11508MARYLANDNo
21223P0106XDentistOral and Maxillofacial Pathology5326DISTRICT OF COLUMBIANo
31223P0106XDentistOral and Maxillofacial Pathology11508MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15486025MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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