David C Bastacky, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

10337 Issued in MD

Practice address

516 N Rolling Rd
Suite 104
Baltimore, MD 21228-4140

Phone

(410) 744-4222

Fax

(410) 744-2472

NPI assigned

Jul 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• David C Bastacky DMD PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Baltimore, MD
  • NPI 1245355312
  NPD (past) Authorized official
• Johns Hopkins University

  • General Practice Dentistry
  • Baltimore, MD
  • NPI 1033190442
  NPD
• Johns Hopkins University

  • Ophthalmology Physician
  • Belcamp, MD
  • NPI 1376342774
  NPD
• Johns Hopkins University

  • Pain Medicine (Anesthesiology) Physician
  • Baltimore, MD
  • NPI 1922008549
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1164429387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 N ROLLING RD",
            "address_2": "SUITE 104",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212284140",
            "telephone_number": "410-744-4222",
            "fax_number": "410-744-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 N ROLLING RD",
            "address_2": "SUITE 104",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212284140",
            "telephone_number": "410-744-4222",
            "fax_number": "410-744-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTACKY",
        "first_name": "DAVID",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MD",
            "license": "10337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Spear Bassett, PH.D.
• Naresh Bassi, M.D.
• Kirolos Bassile, DMD
• Holly Bassler, LMSW
• Gregory Ashton Bassmann, MD
• Larry Bastfield
• Berny Bastiampillai, M.D.
• Ahmaad Jahshua Bastien, DPT
• Jean R Bastien, MD
• Rachelle Bastien

• Oral & Maxillofacial Surgery (D.M.D.) in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.