SOUTHERN MARYLAND ORAL & MAXILLOFACIAL SURGERY (NPI# 1174559298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174559298 |
| Entity Type | Organization |
| Organization Name | SOUTHERN MARYLAND ORAL & MAXILLOFACIAL SURGERY |
| Practice Address |
3450 Old Washington Rd Suite 201 Waldorf MD 20602-3248 |
| Practice Telephone | 3016456911 |
| Practice Fax Number | 3018430083 |
| Mailing Telephone | 3016456911 |
| Mailing Fax Number | 3018430083 |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOHN J HEFFRON (PRESIDENT) |
| Authorized Official Telephone | 3018073230 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5594 | MD | Dental Providers |
| Street Address |
3450 OLD WASHINGTON RD SUITE 201 |
| City | WALDORF |
| State | MD |
| Zip Code | 20602-3248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558364208 | Tuan D Pham Dmd & Joseph A Maloney Dds, LLC | Dentist | 3450 Old Washington Rd, Ste 204, Waldorf, MD 20602-3250 | 2005-05-24 |
| 1184260580 | Ub Waldorf Dental | Clinic/Center | 3450 Old Washington Rd, Waldorf, MD 20602-3248 | 2019-11-20 |
| 1396182150 | Southern Maryland Chiropractic Center David E. Kane PC | Chiropractor | 3450 Old Washington Rd, Suite 101, Waldorf, MD 20602-3248 | 2013-06-03 |
| 1023451325 | Michia Johnson | Dentist | 3450 Old Washington Rd, Suite 200, Waldorf, MD 20602-3248 | 2013-04-17 |
| 1861835431 | Children's Pediatricians & Associates, LLC | Pediatrics | 3450 Old Washington Rd, Suite 100, Waldorf, MD 20602-3248 | 2013-04-12 |
| 1417143041 | Advanced Surgicare of Maryland P.a | Specialist | 3450 Old Washington Rd, Suite 202, Waldorf, MD 20602-3248 | 2007-09-18 |
| 1720206451 | Tuan Pham | Dentist | 3450 Old Washington Rd, Ste 204, Waldorf, MD 20602-3248 | 2007-04-20 |
| 1083772123 | Bradley J Olson | Dentist | 3450 Old Washington Rd, Suite 301, Waldorf, MD 20602 | 2006-12-04 |
| 1427123983 | David Edward Kane | Chiropractor | 3450 Old Washington Rd, Suite 101, Waldorf, MD 20602-3248 | 2006-11-21 |
| 1922199884 | Todd Joseph Sheffler | Dentist | 3450 Old Washington Rd, Suite 302, Waldorf, MD 20602-3248 | 2006-09-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053964957 | Haeyoung Choi | Pharmacist | 25 Smallwood Village Center, Waldorf, MD 20602 | 2019-07-19 |
| 1679137194 | Brighter Days Family Services Inc | Counselor | 11680 Doolittle Dr #111, Waldorf, MD 20602 | 2019-04-30 |
| 1396227039 | Lantern Family Services Inc | Community/Behavioral Health | 11680 Doolittle Dr Ste 111, Waldorf, MD 20602 | 2018-08-29 |
| 1093294910 | Metropolitan Vascular Institute LLC | Internal Medicine | 12070 Old Line Ctr Ste 100, Waldorf, MD 20602 | 2018-08-10 |
| 1174009922 | Dr. Arthur B. Sorkin, D.d.s., LLC | Dentist | 3460 Old Washington Rd., Suite 301-b, Waldorf, MD 20602 | 2018-07-16 |
| 1467945030 | Donna Marie Conley-shaw | Behavior Technician | 16 Pagnell Cir, Waldorf, MD 20602 | 2018-06-08 |
| 1811404296 | Loni Berbaum | Speech-Language Pathologist | 4817 Elmley Pl Apt 315, Waldorf, MD 20602 | 2018-01-06 |
| 1891224853 | Linda E Smith | Social Worker | 605 Pst Office Road, #301, Waldorf, MD 20602 | 2017-06-05 |
| 1104373273 | Love Ngum Che | Pharmacist | 25 Smallwood Village, Waldorf, MD 20602 | 2016-09-07 |
| 1639543341 | Matengy Toure | Pharmacist | 129 St Charles Pkwy, Waldorf, MD 20602 | 2015-11-18 |
| Find all providers in zip 20602 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679875033 | King Oral Surgery Group | Dentist | 11885 Holly Ln Ste 2, Waldorf, MD 20601-3187 | 2010-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508490707 | Carl Ruderman Dds LLC | Dentist | 6309 Baltimore Ave Ste 202, Riverdale, MD 20737-1059 | 2020-02-26 |
| 1740810845 | Akeso Columbia Office LLC | Dentist | 6798 Oak Hall Ln Ste A-1, Columbia, MD 21045-4892 | 2020-01-17 |
| 1245742741 | Akeso Orafacial Maxillary Surgery | Dentist | 7544 Belair Road, Nottingham, MD 21236 | 2017-10-25 |
| 1710436407 | Central Maryland Oral and Facial Surgical Arts of Clarksville, LLC | Dentist | 12431 Clarksville Pike, Route 108, Clarksville, MD 21029 | 2016-09-23 |
| 1356726301 | Jak LLC | Dentist | 352 Thompson Creek Mall, Stevensville, MD 21666-2500 | 2015-07-20 |
| 1548661614 | Ib Dental II, P.C. | Dentist | 30a Audrey Lane, Oxon Hill, MD 20745-1301 | 2014-09-09 |
| 1457764052 | Xun Joy Chen | Dentist | 15005 Shady Grove Rd Ste 420, Rockville, MD 20850-6321 | 2014-06-11 |
| 1164848370 | Maryland Oral Surgery Associates of Frederick, LLC | Dentist | 161 Thomas Johnson Dr Ste 295, Frederick, MD 21702-4314 | 2014-03-12 |
| 1013345511 | The Oral Surgery Center At Mitchellville | Dentist | 12164 Central Ave Ste 224, Mitchellville, MD 20721-1903 | 2013-10-17 |
| 1992142806 | Nkemakonam Egolum | Dentist | 4175 N Hanson Ct Ste 200, Bowie, MD 20716 | 2013-05-31 |
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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.