Individual provider Active NPI

Suzanne Chantel Setayesh, DDS

  • Dentist
  • Baltimore, MD
National Provider Identifier
1659551067
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12068 Issued in MD
Practice address
1501 Division St
Baltimore, MD 21217-3121
Phone
(410) 383-8300
Fax
(301) 838-3160
NPI assigned
Nov 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12068 MD Primary

Addresses

Primary practice location

1501 Division St
Baltimore, MD 21217-3121

Mailing address

1501 Division St
Baltimore, MD 21217-3121
Phone (410) 383-8300

Other practice location 1

1111 Washington Blvd
Baltimore, MD 21230-1824
Phone (301) 383-8300

Other identifiers 1

IdentifierTypeStateIssuer
031395500MedicaidMD

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
I20240116003186 MD Practitioner - Dentist 2567718661 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12068MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Total Health Care Inc CurrentSince Dec 9, 2023 Accepting new patients
Total Health Care Inc. CurrentSince Dec 9, 2023 Accepting new patients
Beltsville Family Dental Ctr.LLC Dentist Past Accepting new patients

Locations

1111 Washington Blvd
Baltimore, MD 21230
Phone (410) 783-1859

1501 Division St
Baltimore, MD 21217
Phone (410) 735-5390

1501 W Saratoga St
Baltimore, MD 21223
Phone (410) 383-7197

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GJFJBD

Organizations & group practices 3

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": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1659551067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 DIVISION ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212173121",
            "telephone_number": "410-383-8300",
            "fax_number": "301-838-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 DIVISION ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212173121",
            "telephone_number": "410-383-8300",
            "fax_number": "301-838-3160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212301824",
            "country_code": "US",
            "telephone_number": "301-383-8300",
            "fax_number": "301-383-3160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SETAYESH",
        "first_name": "SUZANNE",
        "middle_name": "CHANTEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "12068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031395500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.