NPIMap

Organization Active NPI

Tom Fenlon DDS PC

  • Dentist
  • West Friendship, MD
National Provider Identifier
1548638430
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
TOM FENLON DDS PC
Practice address
12800 Frederick Rd
Suite 102
West Friendship, MD 21794-9564
Phone
(410) 442-2800
NPI assigned
Sep 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Authorized official

Name
Thomas J Fenlon, DDSNPI 1801920129
Title
President/Owner
Phone
(410) 442-2800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
Customized Equipment (DME) 332BC3200X 5942 MD

Addresses

Primary practice location

12800 Frederick Rd
Suite 102
West Friendship, MD 21794-9564

Mailing address

PO Box 340
West Friendship, MD 21794-0340
Phone (410) 442-2800

Other practice location 1

2465 Route 97 Ste 12
Glenwood, MD 21738-9749
Phone (410) 489-7565

National Provider Directory

National Provider Directory

Locations

2465 Route 97
Ste 12
Glenwood, MD 21738
Phone (410) 489-7565

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1548638430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "WEST FRIENDSHIP",
            "state": "MD",
            "postal_code": "217940340",
            "telephone_number": "410-442-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 FREDERICK RD",
            "address_2": "SUITE 102",
            "city": "WEST FRIENDSHIP",
            "state": "MD",
            "postal_code": "217949564",
            "telephone_number": "410-442-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2465 Route 97 Ste 12",
            "address_purpose": "LOCATION",
            "city": "Glenwood",
            "state": "MD",
            "postal_code": "217389749",
            "country_code": "US",
            "telephone_number": "410-489-7565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TOM FENLON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-09",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "FENLON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "410-442-2800",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "MD",
            "license": "5942",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Friendship, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.