DR. LEILA NEZAKATGOO (NPI# 1235280652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235280652 |
| Entity Type | Individual |
| Full Name | DR. LEILA NEZAKATGOO |
| Credential | D.M.D. |
| Practice Address |
198 Thomas Johnson Dr Suite #103 Frederick MD 21702-4398 |
| Mailing Address |
5440 Marinelli Rd North Bethesda MD 20852-2500 |
| Practice Telephone | 3016209666 |
| Practice Fax Number | 3016209739 |
| Mailing Telephone | 2022776730 |
| Mailing Fax Number | 3016209739 |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
13622 | MD | Dental Providers |
| Street Address |
198 THOMAS JOHNSON DR SUITE #103 |
| City | FREDERICK |
| State | MD |
| Zip Code | 21702-4398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932104007 | Kenneth James Benjamin | Podiatrist | 198 Thomas Johnson Dr, Ste 4, Frederick, MD 21702-4398 | 2005-06-16 |
| 1225587538 | Oasis Therapy | Physical Therapist | 198 Thomas Johnson Dr, Suite 19, Frederick, MD 21702-4398 | 2016-09-27 |
| 1053718544 | Mustardseed Healthcare Services, LLC | Home Health | 198 Thomas Johnson Dr, Ste 205, Frederick, MD 21702-4398 | 2014-11-26 |
| 1477986099 | Ghulam Abbas, Md LLC | Internal Medicine | 198 Thomas Johnson Dr, 104, Frederick, MD 21702-4398 | 2013-08-19 |
| 1700128436 | Alysia Mason Feuer | Dietitian, Registered | 198 Thomas Johnson Dr, Suite 14, Frederick, MD 21702-4398 | 2013-03-20 |
| 1245582832 | Potomac Healthcare Alliance LLC | Clinic/Center | 198 Thomas Johnson Dr, Suite 5, Frederick, MD 21702-4398 | 2012-10-08 |
| 1700137940 | John P O'brien | Social Worker | 198 Thomas Johnson Dr, Ste 9, Frederick, MD 21702-4443 | 2012-09-27 |
| 1063786044 | Dr. Riku Mukherjee, D.d.s., P.a. | Dentist | 198 Thomas Johnson Dr, Suite 18, Frederick, MD 21702-4398 | 2012-03-08 |
| 1568731917 | David Morra | Dentist | 198 Thomas Johnson Dr, Frederick, MD 21702-4398 | 2011-12-14 |
| 1164666905 | Brett Everette Weedon | Dentist | 198 Thomas Johnson Dr, Suite 203, Frederick, MD 21702-4398 | 2009-04-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129714 | Rita Akowuah | Nurse Practitioner | 1302 Baker Place East Apt 14, Frederick, MD 21702 | 2020-09-18 |
| 1912416272 | Morgan Nicely | Behavior Technician | 65 Thomas Johnson Drive Suite A, Frederick, MD 21702 | 2017-09-29 |
| 1154840494 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 184 Thomas Johnson Dr Ste 104, Frederick, MD 21702 | 2017-09-19 |
| 1831617471 | Hazel Elizabeth Gill | Physical Therapy Assistant | 2007 Butterfield Overlook, Frederick, MD 21702 | 2017-09-05 |
| 1831610161 | William Haynes | Nurse Practitioner | 103 Water Land Ct., Frederick, MD 21702 | 2017-06-27 |
| 1497299333 | Timothy Stimach | Pharmacist | 1430b W Patrick St, Frederick, MD 21702 | 2016-12-12 |
| 1184167405 | Maryland Nutrition and Diet Services, L.L.C. | Dietitian, Registered | 1301 W. 7th Street, No. 1607, Frederick, MD 21702 | 2016-11-18 |
| 1649649468 | Oluwakemi Olubunmi Osidele | Nurse Practitioner | 188 Thomas Johnson Dr Ste 102, Frederick, MD 21702 | 2015-09-22 |
| 1841678562 | Ventzislava Hristova | Spec/Tech, Pathology | 1050 Boyles St. Building 560 Room 12-39, National Cancer Institute - Frederick, Frederick, MD 21702 | 2015-05-14 |
| 1023404571 | Mychal Lynn Pilia | Advanced Practice Midwife | 7420 Hayward Road, Suite 104, Frederick, MD 21702 | 2015-04-11 |
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| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245716232 | Tj Orthodontics | Dentist | 198 Thomas Johnson Dr Ste 103, Frederick, MD 21702-4432 | 2018-07-13 |
| 1114388469 | Stanley Jay Robison | Dentist | 2090 Old Farm Dr Ste F, Frederick, MD 21702-5404 | 2016-03-15 |
| 1891948709 | Rosanne M. Bloom | Dentist | 130 Thomas Johnson Dr., Suite 2, Frederick, MD 21702-4582 | 2008-10-23 |
| 1770707390 | Robert Cina | Dentist | 100 Tuscanny Dr, Suite D, Frederick, MD 21702-5958 | 2007-04-13 |
| 1225155583 | Jon Arthur Moles | Dentist | 3549 Urbana Pike, Frederick, MD 21704-7741 | 2007-03-23 |
| 1912039769 | Christopher Joseph Mctavish | Dentist | 3500 Campus Dr, Suite 104, Frederick, MD 21704-7922 | 2007-03-09 |
| 1427102961 | Bloom & Reddy Dds PC | Dentist | 130 Thomas Johnson Drive, Suite 2, Frederick, MD 21702-4582 | 2007-01-22 |
| 1164509022 | Charles Jeffrey Bowman | Dentist | 10 W College Ter, Suite 240, Frederick, MD 21701-4909 | 2006-10-31 |
| 1962519090 | Lobat Zainali | Dentist | 490 Prospect Blvd., Suite#c, Frederick, MD 21701 | 2006-08-24 |
| 1952312209 | Jerrold J. Pollack,d.d.s.,p.a | Dentist | 1133 Keswick Pl, Frederick, MD 21703-6168 | 2006-08-11 |
| 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.