Aesthetic Dermatology and Dermatologic Surgery Center
NPI 1104068790 · Specialist · Bowie, MD
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Aesthetic Dermatology and Dermatologic Surgery Center is a Specialist organization in Bowie, MD (NPI 1104068790).
Provider details
- NPI number
- 1104068790
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Debra Coats-Walton, Medical Director(301) 809-4321
- License
- D0051777 (MD)
Specialties & taxonomies
Other Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2009-03-30
- Last updated
- 2018-08-27
Frequently asked questions
- What is Aesthetic Dermatology and Dermatologic Surgery Center's NPI number?
- Aesthetic Dermatology and Dermatologic Surgery Center's National Provider Identifier (NPI) is 1104068790, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Aesthetic Dermatology and Dermatologic Surgery Center?
- Aesthetic Dermatology and Dermatologic Surgery Center is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is Aesthetic Dermatology and Dermatologic Surgery Center located?
- Aesthetic Dermatology and Dermatologic Surgery Center's practice location on file with NPPES is 4321 Collington Rd, Bowie, MD 20716.
- What is Aesthetic Dermatology and Dermatologic Surgery Center's phone number?
- The practice phone number listed in the NPPES registry for Aesthetic Dermatology and Dermatologic Surgery Center is (301) 809-4321.
- Does Aesthetic Dermatology and Dermatologic Surgery Center accept Medicare?
- Aesthetic Dermatology and Dermatologic Surgery Center is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Aesthetic Dermatology and Dermatologic Surgery Center?
- The authorized official listed on Aesthetic Dermatology and Dermatologic Surgery Center's NPPES record is Debra Coats-Walton, Medical Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Aesthetic Dermatology and Dermatologic Surgery Center's NPI active?
- Yes — Aesthetic Dermatology and Dermatologic Surgery Center's NPI (1104068790) is active in the NPPES registry as of the last update on 2018-08-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.