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General NPI Number Information
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NPI Number | 1316805450
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Entity Type | Organization
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Legal Business Name | THE DENTAL GROUP BY SMILE LOFT
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 6200 BALTIMORE AVE
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City | RIVERDALE
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State | MD
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Zip | 20737-1054
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Country | US
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Telephone | 240-956-4956
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Fax |
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Provider Business Mailing Address
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Address Line | 6100 CHEVY CHASE DR STE 101
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City | LAUREL
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State | MD
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Zip | 20707-2995
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Country | US
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Telephone | 240-956-4956
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | VAIBHAV RAI
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Credential | DDS
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Telephone | 240-956-4956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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