Individual provider Active NPI

Robert Stuart Maupin, D.D.S., P.A.

  • General Practice Dentistry
  • Lisbon, MD
National Provider Identifier
1275558124
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11820 Issued in MD
Practice address
16036 Frederick Road
Lisbon, MD 21765
Phone
(410) 489-4200
Fax
(410) 489-7871
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11820 MD Primary

Addresses

Primary practice location

16036 Frederick Road
Lisbon, MD 21765

Mailing address

2750 Cold Saturday Dr
Finksburg, MD 21048-2232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211008002334 NC Practitioner - Dentist 4183022916 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12582NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University CurrentSince Sep 1, 2021 Accepting new patients
East Carolina University CurrentSince Sep 1, 2021 Accepting new patients
East Carolina University Current Accepting new patients

Locations

1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275558124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 COLD SATURDAY DR",
            "city": "FINKSBURG",
            "state": "MD",
            "postal_code": "210482232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16036 FREDERICK ROAD",
            "city": "LISBON",
            "state": "MD",
            "postal_code": "21765",
            "telephone_number": "410-489-4200",
            "fax_number": "410-489-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUPIN",
        "first_name": "ROBERT",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "D.D.S., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisbon, MD

Sources for this page

Verify at the official NPI Registry.