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SEVERN PEDIATRIC DENTISTRY
NPI 1376065193
Dentist - Pediatric Dentistry in Odenton, MD

Active since July 13, 2017
2288 BLUE WATER BLVD STE 328, ODENTON, MD 21113(410) 995-8000 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Jul 13, 2017 (2 updates tracked since 2017).

About Severn Pediatric Dentistry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEVERN PEDIATRIC DENTISTRY (NPI 1376065193) is a healthcare organization registered as a pediatric dentistry in Odenton, Maryland and active in the NPI registry since July 2017. The organization lists Soe T Mon, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1376065193
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameSUPER KIDS TEETH LLC
Location Address2288 BLUE WATER BLVD STE 328Odenton, MD 21113-3309
Mailing Address2288 Blue Water Blvd Ste 328Odenton, MD 21113-3309 · (410) 995-8000
Phone(410) 995-8000
Organization SubpartNo
Authorized OfficialSoe T MonCo-owner · (410) 995-8000
Enumeration DateJuly 13, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1376065193 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
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.
2288 BLUE WATER BLVD STE 328, Odenton, MD 21113
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Other Names 1

Doing Business AsSevern Pediatric Dentistry

Other Identifiers 1

Medicaid59291MD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Super Kids Teeth LLC's NPI number?

The NPI number for Super Kids Teeth LLC is 1376065193. It was assigned to this organization in the NPPES registry on July 13, 2017. The provider is doing business as Severn Pediatric Dentistry.

Where is Super Kids Teeth LLC located?

Super Kids Teeth LLC is located at 2288 Blue Water Blvd Ste 328, Odenton, MD 21113. The listed phone number is (410) 995-8000.

What is Super Kids Teeth LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Super Kids Teeth LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.