Julio Abrahan Bermudez, DMD – Dentist in Pasadena, MD

Key facts

NPI: 1346971058
Entity type: Individual (NPI type 1)
Primary specialty: Dentist 122300000X
License: 17474 (MD)
Practice address: 8055 Ritchie Hwy Ste 102
Pasadena, MD 21122-1074
Phone: (954) 483-6999
NPI assigned: Jun 22, 2022
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
17474	MD	MD	Pediatric Physical Therapist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	17474	MD	Yes

Addresses

Primary practice location

8055 Ritchie Hwy Ste 102
Pasadena, MD 21122-1074

Mailing address

1211 S Conkling St Apt 513
Baltimore, MD 21224-5349
Phone (954) 483-6999

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 22, 2022.

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1346971058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S CONKLING ST APT 513",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245349",
            "telephone_number": "954-483-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8055 RITCHIE HWY STE 102",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211221074",
            "telephone_number": "954-483-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "JULIO",
        "middle_name": "ABRAHAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "17474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, MD

All providers in Pasadena, MD · Dentist in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.