NPIMap

Organization Active NPI

Bethany Serafin Awalt, DMD, PA

Doing business as Valley Village Oral Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Pikesville, MD
National Provider Identifier
1376861088
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
4876 Issued in MD
Legal business name
BETHANY SERAFIN AWALT, DMD, PA
Doing business as
Valley Village Oral Surgery Associates
Practice address
2 Reservoir Circle
Suite 103
Pikesville, MD 21208
Phone
(410) 581-9008
Fax
(410) 581-6720
NPI assigned
May 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Authorized official

Name
Dr. Bethany S Awalt, DMDNPI 1043251507
Title
Owner
Phone
(410) 581-9008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 4876 MD Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 14054 MD

Addresses

Primary practice location

2 Reservoir Circle
Suite 103
Pikesville, MD 21208

Mailing address

2 Reservoir Circle
Suite 103
Pikesville, MD 21208
Phone (410) 581-9008

Other names 1

  • Valley Village Oral Surgery Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bethany Serafin Awalt DMD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2 Reservoir Cir
Ste 103
Pikesville, MD 21208
Phone (410) 581-9008

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1376861088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 RESERVOIR CIRCLE",
            "address_2": "SUITE 103",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "21208",
            "telephone_number": "410-581-9008",
            "fax_number": "410-581-6720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 RESERVOIR CIRCLE",
            "address_2": "SUITE 103",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "21208",
            "telephone_number": "410-581-9008",
            "fax_number": "410-581-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY SERAFIN AWALT, DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-06",
        "last_updated": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "AWALT",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-581-9008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "4876",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "14054",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Village Oral Surgery Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.