Individual provider Active NPI

Michael Joseph Dodd, MD

  • Ophthalmology Physician
  • Prince Frederick, MD
National Provider Identifier
1407807340
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D16760 Issued in MD
Practice address
800 Prince Frederick Blvd
Prince Frederick, MD 20678
Phone
(410) 535-2270
Fax
(410) 535-9549
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D16760 MD Primary

Addresses

Primary practice location

800 Prince Frederick Blvd
Prince Frederick, MD 20678

Mailing address

800 Prince Frederick Blvd
Prince Frederick, MD 20678-3145
Phone (410) 535-2270

Other identifiers 2

IdentifierTypeStateIssuer
185221300MedicaidMD
C0740001OtherFED BC

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D16760MDMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1407807340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 PRINCE FREDERICK BLVD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783145",
            "telephone_number": "410-535-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRINCE FREDERICK BLVD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "20678",
            "telephone_number": "410-535-2270",
            "fax_number": "410-535-9549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODD",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D16760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185221300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED BC",
            "identifier": "C0740001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.