NPIMap

Organization Active NPI

Good Samaritan Dental & Surgical Assoc

  • Dentist
  • Baltimore, MD
National Provider Identifier
1184847758
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9971 Issued in MD
Legal business name
GOOD SAMARITAN DENTAL & SURGICAL ASSOC
Practice address
5601 Loch Raven Blvd.
Suite 209
Baltimore, MD 21239
Phone
(410) 532-4900
Fax
(410) 532-4951
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ross Dymond, DDSNPI 1255537213
Title
Dentist
Phone
(410) 532-4900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 9971 MD Primary

Addresses

Primary practice location

5601 Loch Raven Blvd.
Suite 209
Baltimore, MD 21239

Mailing address

5601 Loch Raven Blvd.
Suite 209
Baltimore, MD 21239
Phone (410) 532-4900

National Provider Directory

National Provider Directory

Locations

5601 Loch Raven Blvd
Ste 209
Baltimore, MD 21239
Phone (410) 532-4900

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184847758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD.",
            "address_2": "SUITE 209",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21239",
            "telephone_number": "410-532-4900",
            "fax_number": "410-532-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD.",
            "address_2": "SUITE 209",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21239",
            "telephone_number": "410-532-4900",
            "fax_number": "410-532-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN DENTAL & SURGICAL ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DYMOND",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "410-532-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "9971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.