Kreisheh,, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KREISHEH,, LLC

Doing business as

Charm City Smiles

Practice address

21 E Padonia Rd
Lutherville Timonium, MD 21093-2306

Phone

(410) 913-5700

Fax

(410) 842-0205

NPI assigned

Jul 29, 2020

Organization subpart

No

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

Authorized official

Name

George Kreisheh, DMDNPI 1386174589

Title

Dentist

Phone

(410) 913-5700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Charm City Smiles Doing business as

Electronic endpoints 1

Locations

Practitioners 2

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

• George Kreisheh, DMD

  • General Practice Dentistry
  • Lutherville Timonium, MD
  • NPI 1386174589
  NPD Authorized official
• Fadi Kreisheh, DMD

  • General Practice Dentistry
  • Lutherville, MD
  • NPI 1508473349
  NPD

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1558970137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 E PADONIA RD",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210932306",
            "telephone_number": "410-913-5700",
            "fax_number": "410-842-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 E PADONIA RD",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210932306",
            "telephone_number": "410-913-5700",
            "fax_number": "410-842-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KREISHEH,, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "KREISHEH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "410-913-5700",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "907707300",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "charmcitysmilesmd.com",
            "affiliation": "N",
            "address_1": "21 E Padonia Rd",
            "city": "Lutherville Timonium",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210932306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Charm City Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hailey Lape Kerschner, LCSW-C
• Autumn Cassidy Kidd, PT, DPT
• Christina J Kim, LCSW
• Lorin A Kotz, LGPC
• George Kreisheh, DMD
• Dana Kresslein, LMSW
• Bridgit Lacy-Wolak, LCSW-C
• Stephanie Lamont, BS, CACAD
• Lang Orthodontics
• Laurie Beth Lawhorn, LCSW-C

• General Practice Dentistry in Lutherville Timonium, MD
• Providers in Lutherville Timonium, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.