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LAUREL LAKES PEDIATRIC DENTISTRY
NPI 1649717638
Dentist - Pediatric Dentistry in Laurel, MD

Active since January 27, 2017
13964 BALTIMORE AVE, SUITE C6, LAUREL, MD 20707(202) 276-0649(631) 857-7860 Get Directions Write a Review

NPPES record last updated: July 20, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 20, 2018, Jun 26, 2017, Feb 2, 2017 and 1 more (4 updates tracked since 2017).

About Laurel Lakes Pediatric Dentistry NPPES

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

LAUREL LAKES PEDIATRIC DENTISTRY (NPI 1649717638) is a healthcare organization registered as a pediatric dentistry in Laurel, Maryland and active in the NPI registry since January 2017. The organization lists Antionette C. Wilson, Owner, as its authorized official.

NPPES Registry Identity

NPI1649717638
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameLAUREL LAKES PEDIATRIC DENTISTRY, LLC
Location Address13964 BALTIMORE AVE, SUITE C6Laurel, MD 20707
Mailing Address401 Church St, Suite 2210Nashville, TN 37219-2310 · (615) 988-2627 · Fax (631) 857-7860
Phone(202) 276-0649
Fax(631) 857-7860
Organization SubpartNo
Authorized OfficialAntionette C. WilsonOwner · (202) 276-0649
Enumeration DateJanuary 27, 2017
Last NPPES UpdateJuly 20, 20184 updates tracked since enumeration
✔ NPI 1649717638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in MD · 13970
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.
13964 BALTIMORE AVE, Laurel, MD 20707
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Other Names 1

Doing Business AsLaurel Lakes Pediatric Dentistry

Other Identifiers 1

Other13970MD · Dental License

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

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 Laurel Lakes Pediatric Dentistry, LLC's NPI number?

The NPI number for Laurel Lakes Pediatric Dentistry, LLC is 1649717638. It was assigned to this organization in the NPPES registry on January 27, 2017. The provider is doing business as Laurel Lakes Pediatric Dentistry.

Where is Laurel Lakes Pediatric Dentistry, LLC located?

Laurel Lakes Pediatric Dentistry, LLC is located at 13964 Baltimore Ave Suite C6, Laurel, MD 20707. The listed phone number is (202) 276-0649.

What is Laurel Lakes Pediatric Dentistry, LLC's specialty?

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

What insurance does Laurel Lakes Pediatric Dentistry, LLC accept?

Health plans from UnitedHealthcare list Laurel Lakes Pediatric Dentistry, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Laurel Lakes Pediatric Dentistry, LLC was last updated on July 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.