Active NPI
Timonium Dental & Specialty LLC
- Dentist
- Timonium, MD
National Provider Identifier
1508399080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Legal business name
- TIMONIUM DENTAL & SPECIALTY LLC
- Practice address
- 2135 York Rd Ste a
Timonium, MD 21093-3137 - Phone
- (410) 910-9641
- NPI assigned
- Apr 11, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bryan Fitzgerald, DDS
- Title
- Owner
- Phone
- (410) 910-9641
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | Primary | ||
| Endodontics | 1223E0200X | |||
| General Practice Dentistry | 1223G0001X | |||
| Periodontics | 1223P0300X | |||
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | |||
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X |
Addresses
Primary practice location
2135 York Rd Ste a
Timonium, MD 21093-3137
Mailing address
46 Vreeland Dr Ste 6
Skillman, NJ 08558-2638
Phone (609) 252-9000
Other names 1
- BluePointe Dental (Timonium)
National Provider Directory
National Provider DirectoryLocations
2135 York Rd
Ste A
Timonium, MD 21093
Phone (410) 910-9641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491868800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1491868800000",
"number": "1508399080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 VREELAND DR STE 6",
"city": "SKILLMAN",
"state": "NJ",
"postal_code": "085582638",
"telephone_number": "609-252-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2135 YORK RD STE A",
"city": "TIMONIUM",
"state": "MD",
"postal_code": "210933137",
"telephone_number": "410-910-9641"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TIMONIUM DENTAL & SPECIALTY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-04-11",
"last_updated": "2017-04-11",
"status": "A",
"authorized_official_last_name": "FITZGERALD",
"authorized_official_first_name": "BRYAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "410-910-9641",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": null,
"license": null,
"primary": true
},
{
"code": "1223E0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Endodontics",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Periodontics",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "BluePointe Dental (Timonium)",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Timonium, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.