OrganizationActive
Laurel Lakes Pediatric Dentistry, LLC
NPI 1649717638 · Pediatric Dentistry · Laurel, MD
Laurel Lakes Pediatric Dentistry, LLC is a Pediatric Dentistry organization in Laurel, MD (NPI 1649717638).
Provider details
- NPI number
- 1649717638
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Antionette Wilson, Owner(202) 276-0649
- License
- 13970 (MD)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
13964 Baltimore Ave
Suite C6
Laurel, MD 20707
Phone: (202) 276-0649
Fax: (631) 857-7860
Street-level locationGet directions
Mailing address
401 Church St
Nashville, TN 37219-2310
Other names (DBA / former)
- Doing business as
- Laurel Lakes Pediatric Dentistry
- Doing business as
- Laurel Lakes Pediatric Dentistry
Registry dates
- Enumerated
- 2017-01-27
- Last updated
- 2018-07-20
Frequently asked questions
- What is Laurel Lakes Pediatric Dentistry, LLC's NPI number?
- Laurel Lakes Pediatric Dentistry, LLC's National Provider Identifier (NPI) is 1649717638, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Laurel Lakes Pediatric Dentistry, LLC?
- Laurel Lakes Pediatric Dentistry, LLC is classified in the NPPES registry as Pediatric Dentistry (Dental Providers).
- Where is Laurel Lakes Pediatric Dentistry, LLC located?
- Laurel Lakes Pediatric Dentistry, LLC's practice location on file with NPPES is 13964 Baltimore Ave, Laurel, MD 20707.
- What is Laurel Lakes Pediatric Dentistry, LLC's phone number?
- The practice phone number listed in the NPPES registry for Laurel Lakes Pediatric Dentistry, LLC is (202) 276-0649.
- Who is the authorized official for Laurel Lakes Pediatric Dentistry, LLC?
- The authorized official listed on Laurel Lakes Pediatric Dentistry, LLC's NPPES record is Antionette Wilson, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Laurel Lakes Pediatric Dentistry, LLC's NPI active?
- Yes — Laurel Lakes Pediatric Dentistry, LLC's NPI (1649717638) is active in the NPPES registry as of the last update on 2018-07-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.