North Baltimore Dental, Mark R. Bedford DDS Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15902 Issued in OH

Legal business name

NORTH BALTIMORE DENTAL, MARK R. BEDFORD DDS INC.

Practice address

19680 Idlewood TRL
Strongsville, OH 44149-3136

Phone

(440) 572-1757

Fax

(440) 234-7820

NPI assigned

Jul 10, 2014

Last updated

Jul 10, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark R. Bedford, DDS

Title

President

Phone

(440) 292-5773

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404950400000",
    "number": "1649686676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19680 IDLEWOOD TRL",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441493136",
            "telephone_number": "440-572-1757",
            "fax_number": "440-234-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19680 IDLEWOOD TRL",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441493136",
            "telephone_number": "440-572-1757",
            "fax_number": "440-234-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BALTIMORE DENTAL, MARK R. BEDFORD DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-07-10",
        "status": "A",
        "authorized_official_last_name": "BEDFORD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-292-5773",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "15902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.