Michelle Riach Andersen, DDS
Individual provider Active NPI Dentist · Baltimore, MD
NPI 1477835809 · NPPES record last updated Jul 21, 2012
Key facts
- NPI
- 1477835809
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 15089 (MD)
- Practice address
- 1820 Lancaster St
Suite 100
Baltimore, MD 21231-3584 - Phone
- (410) 929-1808
- NPI assigned
- Sep 12, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 15089 | MD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Andersen Dental LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 15089 | MD | Yes |
Addresses
Primary practice location
1820 Lancaster St
Suite 100
Baltimore, MD 21231-3584
Mailing address
1820 Lancaster St
Suite 100
Baltimore, MD 21231-3584
Other names
- Dr. Michelle Riach
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2012. 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.