Active NPI
Erin Olivia Mondesir, DDS
- General Practice Dentistry
- Baltimore, MD
National Provider Identifier
1225194640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12218
- Practice address
- 5632 The Alameda
Baltimore, MD 21239 - Phone
- (410) 485-0008
- Fax
- (410) 435-0444
- NPI assigned
- Dec 29, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12218 | MD | Primary |
Addresses
Primary practice location
5632 The Alameda
Baltimore, MD 21239
Mailing address
2221 E Bijou St Ste 100
Colorado Springs, CO 80909-8009
Phone (719) 576-1850
Other practice location 1
2111 W Patapsco Ave
Baltimore, MD 21230-2946
Phone (410) 644-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225194640 | Medicaid | MD |
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 |
|---|---|---|---|
| 12218 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ronald B Montano DDS PC | General Practice | Past | Accepting new patients |
| Baltimore South Smiles Youth Dentistry, PC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Baltimore, MD
- NPI 1568473759
-
- General Practice Dentistry
- Baltimore, MD
- NPI 1306254735
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560297600000",
"number": "1225194640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2221 E BIJOU ST STE 100",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809098009",
"telephone_number": "719-576-1850",
"fax_number": "719-955-9470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5632 THE ALAMEDA",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21239",
"telephone_number": "410-485-0008",
"fax_number": "410-435-0444"
}
],
"practiceLocations": [
{
"address_1": "2111 W Patapsco Ave",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212302946",
"country_code": "US",
"telephone_number": "410-644-4100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONDESIR",
"first_name": "ERIN",
"middle_name": "OLIVIA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-29",
"last_updated": "2019-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "12218",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1225194640",
"state": "MD"
}
],
"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 Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.