Healthcare Provider Details
I. General information
NPI: 1801733381
Provider Name (Legal Business Name): ELEVATED OASIS DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12164 CENTRAL AVE STE 213
MITCHELLVILLE MD
20721-1902
US
IV. Provider business mailing address
5811 SAVANNAH DR
BRANDYWINE MD
20613-7765
US
V. Phone/Fax
- Phone: 619-248-0963
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JASMINE
SPRIGGS
Title or Position: DENTIST
Credential: DDS
Phone: 619-248-0963