Provider Demographics
NPI:1326277096
Name:DREAM DENTAL RHODES P.C.
Entity Type:Organization
Organization Name:DREAM DENTAL RHODES P.C.
Other - Org Name:DREAM DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:R
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-334-3435
Mailing Address - Street 1:323 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-1503
Mailing Address - Country:US
Mailing Address - Phone:301-334-3435
Mailing Address - Fax:301-334-3481
Practice Address - Street 1:323 E OAK ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1503
Practice Address - Country:US
Practice Address - Phone:301-334-3435
Practice Address - Fax:301-334-3481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD137361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD012604700Medicaid