CPDG-AM NPI 1891043006

NPI Information

NPI: 1891043006
Provider Name: CPDG-AM
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
7556 TEAGUE RD
SUITE 110
HANOVER, MD
ZIP 21076
Phone: (410) 799-0780
Get Directions

CPDG-AM is a pediatric dentistry dentist in Hanover, MD. The provider is 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. CPDG-AM NPI is 1891043006. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7556 TEAGUE RD
SUITE 110
HANOVER, MD
ZIP 21076-213
Phone: (410) 799-0780
Fax: (410) 799-0781

The provider's authorized official is Hakan Omer Koymen .
The authorized official title is President and has the following contact phone number (410) 248-3384.

The enumeration date for this NPI number is 8/17/2012 and was last updated on 2/6/2017.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0221X	Dentist	Pediatric Dentistry	12770	MARYLAND	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	9200608	MEDICAID	MARYLAND
2	026120300	MEDICAID	MARYLAND
3	008494860	MEDICAID	MARYLAND
4	022999700	MEDICAID	MARYLAND
5	036344800	MEDICAID	MARYLAND

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: 5/5/2024

NPI Synchronization or Removal

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