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Contact Information

LONGMEADOW FAMILY DENTAL CARE
19638 LEITERSBURG PIKE
SUITE 103
HAGERSTOWN, MD21742
 Phone: 301-739-1100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for LONGMEADOW FAMILY DENTAL CARE

NPI Number 1174637185
LBN Legal business name LONGMEADOW FAMILY DENTAL CARE
Authorized official BRANDON ELLIS - (PRES/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/18/2006
Last updated 11/08/2017 - About 9 years ago
Identifiers
MD License # 12508
MD License # 14739
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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