Individual provider Active NPI

Thomas Christopher Llewellyn, DDS

  • Dentist
  • Towson, MD
National Provider Identifier
1275618456
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10666 Issued in MD
Practice address
120 Sister Pierre Drive
Suite 302
Towson, MD 21204-7526
Phone
(410) 821-0100
Fax
(410) 821-0112
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

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
Dentist 122300000X 10666 MD Primary

Addresses

Primary practice location

120 Sister Pierre Drive
Suite 302
Towson, MD 21204-7526

Mailing address

120 Sister Pierre Drive
Suite 302
Towson, MD 21204-7526
Phone (410) 821-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20160526001655 MD Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8527358985

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10666MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Llewellyn, DDS, Assoc. PA Dentist Past Accepting new patients

Organizations & group practices 1

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275618456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DRIVE",
            "address_2": "SUITE 302",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047526",
            "telephone_number": "410-821-0100",
            "fax_number": "410-821-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DRIVE",
            "address_2": "SUITE 302",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047526",
            "telephone_number": "410-821-0100",
            "fax_number": "410-821-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLEWELLYN",
        "first_name": "THOMAS",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "10666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.