Active NPI
Magdalena Pidlaoan Vallar, DMD MPH
- Dentist
- Baltimore, MD
National Provider Identifier
1043433618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DENTIST05522
- Practice address
- 2507 St Paul Street
Baltimore, MD 21218 - Phone
- (410) 243-3111
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DENTIST05522 | MD | Primary |
Addresses
Primary practice location
2507 St Paul Street
Baltimore, MD 21218
Mailing address
3 Jill Court
Reisterstown, MD 21136
Phone (410) 833-5920
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05121 | Other | MD | MD BLUE CROSS BLUE SHIELD |
Other names 1
- Magdalena Avelino Pidlaoan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DENTIST05522 | MD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043433618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 JILL COURT",
"city": "REISTERSTOWN",
"state": "MD",
"postal_code": "21136",
"telephone_number": "410-833-5920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2507 ST PAUL STREET",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21218",
"telephone_number": "410-243-3111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALLAR",
"first_name": "MAGDALENA",
"middle_name": "PIDLAOAN",
"name_prefix": "Dr.",
"credential": "DMD MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "DENTIST05522",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD BLUE CROSS BLUE SHIELD",
"identifier": "05121",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MAGDALENA",
"last_name": "PIDLAOAN",
"middle_name": "AVELINO",
"credential": "DMD MPH",
"code": "5",
"type": "Other Name"
}
]
}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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.