Active NPI
Andrew George Lericos, D.D.S.
- Dentist
- Cockeysville, MD
National Provider Identifier
1124476460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15960
- Practice address
- 9727 Greenside Dr
#101
Cockeysville, MD 21030-5030 - Phone
- (410) 628-0086
- NPI assigned
- May 26, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | 15960 | MD | Primary |
Addresses
Primary practice location
9727 Greenside Dr
#101
Cockeysville, MD 21030-5030
Mailing address
647 Washington Blvd
Baltimore, MD 21230-2215
Phone (443) 416-1431
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 |
|---|---|---|---|
| 15960 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Andrew G Lericos DDS, LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Severna Park, MD
- NPI 1427877158
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464220800000",
"number": "1124476460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "647 WASHINGTON BLVD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212302215",
"telephone_number": "443-416-1431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9727 GREENSIDE DR",
"address_2": "#101",
"city": "COCKEYSVILLE",
"state": "MD",
"postal_code": "210305030",
"telephone_number": "410-628-0086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LERICOS",
"first_name": "ANDREW",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-26",
"last_updated": "2016-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "15960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cockeysville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.