Brian W. Robertson DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

14842 Issued in MD

Legal business name

BRIAN W. ROBERTSON DDS PA

Doing business as

West Baltimore Dental

Practice address

3322 Frederick Ave
Baltimore, MD 21229-3810

Phone

(410) 566-2080

Fax

(410) 566-6379

NPI assigned

Jun 10, 2015

Last updated

Jun 10, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brian Wilson Robertson, DDS

Title

Dentist/Owner

Phone

(410) 566-2080

Specialties & licenses 1

Addresses

Other names 1

• West Baltimore Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alan Selig Eidensohn, D.M.D.

  • General Practice Dentistry
  • Baltimore, MD
  • NPI 1912915216
  NPD (past)

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1497136949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3322 FREDERICK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212293810",
            "telephone_number": "410-566-2080",
            "fax_number": "410-566-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 FREDERICK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212293810",
            "telephone_number": "410-566-2080",
            "fax_number": "410-566-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN W. ROBERTSON DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-10",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "410-566-2080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Baltimore Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Valerie Michelle Brewer, FNP-C
• Elyse Kathleen Brewington
• Richard J Breyer III, MD
• Brian D Schaffer DDS PA
• Brian E Mondell, MD LLC
• Noelle Ann Brickman Williams, CRNP
• Charlene Briddell
• Jamie Briddell, NP-C
• Bridge Integrating Group Practice LLC
• Bridge to Life LLC

• Dentist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; 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.