Active NPI
Marilyn Brodeur, DDS
- Dentist
- Baltimore, MD
National Provider Identifier
1487965836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- NA
- Practice address
- 600 N Wolfe St
Blalock 266
Baltimore, MD 21287-3424 - Phone
- (410) 905-2917
- NPI assigned
- Jun 30, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | NA | MD | Primary |
Addresses
Primary practice location
600 N Wolfe St
Blalock 266
Baltimore, MD 21287-3424
Mailing address
118 N Howard Street
Apt 602
Baltimore, MD 21201
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277856000000",
"number": "1487965836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 N HOWARD STREET",
"address_2": "APT 602",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N WOLFE ST",
"address_2": "BLALOCK 266",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212873424",
"telephone_number": "410-905-2917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODEUR",
"first_name": "MARILYN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-30",
"last_updated": "2010-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "NA",
"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 Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.