Maryam Bemani
Individual provider Active NPI Dentist · College Park, MD
NPI 1659627123 · NPPES record last updated Nov 14, 2013
Key facts
- NPI
- 1659627123
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 15152 (MD)
- Practice address
- 7305 Baltimore Ave Ste 204
College Park, MD 20740-3232 - Phone
- (301) 927-2500
- NPI assigned
- Aug 1, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150716000306 | MD | Order and Referring Only - Dentist |
0042523383 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15152 | MD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| College Park Dental | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 15152 | MD | Yes |
| General Practice Dentistry | 1223G0001X | 15152 | MD |
Addresses
Primary practice location
7305 Baltimore Ave Ste 204
College Park, MD 20740-3232
Mailing address
6127 White Marble CT
Clarksville, MD 21029-1658
Phone (410) 531-5050
Other providers in College Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.