Individual provider Active NPI

Eric S Kneussl, M.S.,D.D.S

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1528127644
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8106 Issued in MD
Practice address
4136 E Joppa Rd
Suite F
Baltimore, MD 21236-2286
Phone
(410) 256-2930
Fax
(410) 256-6020
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8106 MD Primary

Addresses

Primary practice location

4136 E Joppa Rd
Suite F
Baltimore, MD 21236-2286

Mailing address

4136 E Joppa Rd
Suite F
Baltimore, MD 21236-2286
Phone (410) 256-2930

Other identifiers 2

IdentifierTypeStateIssuer
1548370216OtherMDNPI CORP #
G8100001OtherMDPROVIDER #BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150521001170 MD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8224358882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8106MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Abramson & Kneussl PA General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528127644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4136 E JOPPA RD",
            "address_2": "SUITE F",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212362286",
            "telephone_number": "410-256-2930",
            "fax_number": "410-256-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4136 E JOPPA RD",
            "address_2": "SUITE F",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212362286",
            "telephone_number": "410-256-2930",
            "fax_number": "410-256-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEUSSL",
        "first_name": "ERIC",
        "middle_name": "S",
        "credential": "M.S.,D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "8106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI CORP #",
            "identifier": "1548370216",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER #BCBS",
            "identifier": "G8100001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.