Prince Frederick Dental Center
NPI 1164634234ActiveOrganization· Dentist, General Practice· Prince Frederick, MD
Dentist, General Practice in Prince Frederick, Maryland, registered in NPPES in May 2007. The authorized official on file is Audra A. Brown, Office Manager.
Overview
| NPI | 1164634234 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 3, 2007 |
| Last updated in NPPES | Sep 11, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 12676 | MD |
| Dentist, General Practice | 1223G0001X | 12630 | MD |
| Dentist, General Practice | 1223G0001X | 11553 | MD |
| Dentist, General Practice | 1223G0001X | 11869 | MD |
| Dentist, General Practice | 1223G0001X | 8583 | MD |
| Dentist, Periodontics | 1223P0300X | 12518 | MD |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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