NPIMap

Organization Active NPI

Johns Hopkins University

Doing business as Jhu - Dental/Oral Surgery

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1033190442
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JOHNS HOPKINS UNIVERSITY
Doing business as
Jhu - Dental/Oral Surgery
Practice address
600 N Wolfe St
Baltimore, MD 21205-2101
Phone
(410) 614-1732
NPI assigned
Nov 11, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
JOHNS HOPKINS UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shavonda L Keating
Title
Sr Production Unit MGR
Phone
(410) 933-6430

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X MD
General Practice Dentistry 1223G0001X MD Primary
Pediatric Dentistry 1223P0221X MD
Oral and Maxillofacial Surgery (Dentist) 1223S0112X MD

Addresses

Primary practice location

600 N Wolfe St
Baltimore, MD 21205-2101

Mailing address

PO Box 64767
Baltimore, MD 21264-4767

Other identifiers 3

IdentifierTypeStateIssuer
450371600MedicaidMD
768504100MedicaidMD
CD6080OtherMDRRMC

Other names 1

  • JHU - DENTAL/ORAL SURGERY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000719 MD Part B Supplier - Clinic/Group Practice 8921903147 Receives reassigned benefits from 4,764 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
John Hopkins Univ440 organizations share this tax ID, including this one
Part of
John Hopkins Univ

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1033190442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64767",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212052101",
            "telephone_number": "410-614-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNS HOPKINS UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHNS HOPKINS UNIVERSITY",
        "enumeration_date": "2005-11-11",
        "last_updated": "2022-07-21",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "SHAVONDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR PRODUCTION UNIT MGR",
        "authorized_official_telephone_number": "410-933-6430"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "450371600",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "768504100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "CD6080",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JHU - DENTAL/ORAL SURGERY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JHU - DENTAL/ORAL SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.