Mondawmin Mall Dental LLP

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MONDAWMIN MALL DENTAL LLP

Practice address

2401 Liberty Heights Ave
Ste 3725
Baltimore, MD 21215-8019

Phone

(410) 225-0014

NPI assigned

Jun 13, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Rostislav Kraznov

Title

Owner

Phone

(786) 475-7600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1629238571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 LIBERTY HEIGHTS AVE",
            "address_2": "STE 3725",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212158019",
            "telephone_number": "410-225-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 LIBERTY HEIGHTS AVE",
            "address_2": "STE 3725",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212158019",
            "telephone_number": "410-225-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONDAWMIN MALL DENTAL LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-13",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "KRAZNOV",
        "authorized_official_first_name": "ROSTISLAV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-475-7600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Moncrieffe
• Deena Monczyk
• Aviva Mond, MS, CCC-SLP
• Chaim Bernard Mond, MD
• Samhati Mondal, M.D.
• Brian E Mondell, M.D.
• Ethan Mondell
• Cassandra Mondesir
• Erin Olivia Mondesir, DDS
• Melissa Grace Mondich, LCSW-C

• General Practice Dentistry in Baltimore, MD
• Providers in Baltimore, 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 Dec 4, 2014; 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.