Mark Limsam, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17317 Issued in MD

Practice address

4195 Mountain Rd
Pasadena, MD 21122-4455

Phone

(410) 255-8001

Fax

(410) 255-0687

NPI assigned

Jun 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1144715533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4195 MOUNTAIN RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211224455",
            "telephone_number": "410-255-8001",
            "fax_number": "410-255-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4195 MOUNTAIN RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211224455",
            "telephone_number": "410-255-8001",
            "fax_number": "410-255-0687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1851 MacGregor Downs Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278345925",
            "country_code": "US",
            "telephone_number": "828-765-0110",
            "fax_number": "828-765-0123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2460 Wonder Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Kannapolis",
            "state": "NC",
            "postal_code": "280836690",
            "country_code": "US",
            "telephone_number": "704-934-2003",
            "fax_number": "216-584-1142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIMSAM",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11438",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "17317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Pasadena, MD
• Providers in Pasadena, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.