CCDENTAL, LLC – NPI #1518789254
Clinic/Center

CCDENTAL, LLC is an AHC clinic located in FREDERICK, MD. NPPES has assigned the NPI number 1518789254 to CCDENTAL, LLC on October 24, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CCDENTAL, LLC below.

NPI Profile for
CCDENTAL, LLC

NPI Number
1518789254
Enumeration Date

(more than a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CCDENTAL, LLC
Primary location
7810 WORMANS MILL ROAD
STE D
FREDERICK, MD 21701
Phone: (301) 378-2595 Fax: (301) 378-2729
Mailing address
Same as primary location
Organization Subpart
Yes - CCDENTAL, LLC is subpart of another organization.
Authorized Official
MICHAEL PESIN
PARTNER
Phone: (301) 378-2595
Updated
Certification Date
Oct 22, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.