Individual provider Active NPI

Alberto Alejandro, DMD

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1124154844
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14107 Issued in MD
Practice address
2200 Kernan Dr.
Kernan Hospital
Baltimore, MD 21207
Phone
(410) 448-6290
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14107 MD Primary
General Practice Dentistry 1223G0001X 052611-1 NY
General Practice Dentistry 1223G0001X 2540 PR

Addresses

Primary practice location

2200 Kernan Dr.
Kernan Hospital
Baltimore, MD 21207

Mailing address

326 Chamborley Dr
Reisterstown, MD 21136-6149
Phone (410) 702-7300

Other identifiers 1

IdentifierTypeStateIssuer
005890400MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160223001355 MD Order and Referring Only - DentistPractitioner - Dentist 5799080180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
052611-1NYMDGeneral Practice Dentistry
2540PRMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124154844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 CHAMBORLEY DR",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211366149",
            "telephone_number": "410-702-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 KERNAN DR.",
            "address_2": "KERNAN HOSPITAL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21207",
            "telephone_number": "410-448-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEJANDRO",
        "first_name": "ALBERTO",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "14107",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052611-1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2540",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005890400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.