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NPI Code Detail

MEDICARE: THE DENTAL GROUP BY SMILE LOFT

MEDICARE: THE DENTAL GROUP BY SMILE LOFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry
21223P0300XPeriodontics
31223S0112XOral and Maxillofacial Surgery (Dentist)
4261QD0000XDental Clinic/Center
5261QS0112XOral and Maxillofacial Surgery Clinic/Center
61223E0200XEndodontics
71223P0106XOral and Maxillofacial Pathology Dentistry
8122300000XDentist

General Provider Information

NPI Number : 1316805450
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE DENTAL GROUP BY SMILE LOFT
Provider Business Mailing Address
First Line : 6100 CHEVY CHASE DR STE 101
Second Line :
City : LAUREL
State : MD
Zip : 20707-2995
Country : US
Telephone Number : 240-956-4956
Fax Number :
Provider Business Practice Location Address
First Line : 6200 BALTIMORE AVE
Second Line :
City : RIVERDALE
State : MD
Zip : 20737-1054
Country : US
Telephone Number : 240-956-4956
Fax Number :
Authorized Official
Title or Position : CO-OWNER
Name : VAIBHAV RAI
Credential : DDS
Telephone Number : 240-956-4956
Provider Enumeration Date : 01/15/2026
Last Update Date : 01/15/2026

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Directions to “THE DENTAL GROUP BY SMILE LOFT ” Practice Location

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