Individual provider Active NPI

Kevin Matthew Barnes, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Ellicott City, MD
National Provider Identifier
1669220125
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
17920 Issued in MD
Practice address
10045 Baltimore National Pike Ste A1
Ellicott City, MD 21042-3673
Phone
(410) 418-8370
NPI assigned
May 9, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 17920 MD Primary

Addresses

Primary practice location

10045 Baltimore National Pike Ste A1
Ellicott City, MD 21042-3673

Mailing address

1053 W Barre St
Baltimore, MD 21230-2131
Phone (443) 472-7157

Other practice location 1

5961 Exchange Dr Ste 114
Eldersburg, MD 21784-9266
Phone (410) 549-9500

Other practice location 2

1134 N Rolling Rd
Catonsville, MD 21228-3931
Phone (410) 744-0260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17920MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Greenwald Riger Kyser & Wang Orthodontics and Dentofacial Orthopedics PastSince May 12, 2024 Accepting new patients

Organizations & group practices 1

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": "1715212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1669220125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 W BARRE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212302131",
            "telephone_number": "443-472-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10045 BALTIMORE NATIONAL PIKE STE A1",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423673",
            "telephone_number": "410-418-8370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5961 Exchange Dr Ste 114",
            "address_purpose": "LOCATION",
            "city": "Eldersburg",
            "state": "MD",
            "postal_code": "217849266",
            "country_code": "US",
            "telephone_number": "410-549-9500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1134 N Rolling Rd",
            "address_purpose": "LOCATION",
            "city": "Catonsville",
            "state": "MD",
            "postal_code": "212283931",
            "country_code": "US",
            "telephone_number": "410-744-0260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARNES",
        "first_name": "KEVIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "17920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.