Individual provider Active NPI

Deitra Bellamy

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1346467255
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13362 Issued in MD
Practice address
6105 Harford Rd
Baltimore, MD 21214-1312
Phone
(410) 254-5437
Fax
(410) 254-5310
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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 13362 MD Primary

Addresses

Primary practice location

6105 Harford Rd
Baltimore, MD 21214-1312

Mailing address

16 Arcade Unit 198747
Nashville, TN 37219-1994
Phone (615) 750-0337

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

LicenseStateTypeSpecialty
13362MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ib Dental I, P.C. General Practice Past Accepting new patients
Baltimore North 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.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389139200000",
    "number": "1346467255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ARCADE UNIT 198747",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191994",
            "telephone_number": "615-750-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 HARFORD RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212141312",
            "telephone_number": "410-254-5437",
            "fax_number": "410-254-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLAMY",
        "first_name": "DEITRA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2014-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13362",
            "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 Jan 8, 2014; 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.