Active NPI
Brenda Fitzgerald
- Dental Hygienist
- North East, MD
National Provider Identifier
1679029243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 3597
- Practice address
- 2057 Pulasky Hwy.
Suite 2
North East, MD 21901 - Phone
- (410) 287-2323
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 3597 | MD | Primary |
Addresses
Primary practice location
2057 Pulasky Hwy.
Suite 2
North East, MD 21901
Mailing address
2057 Pulasky Hwy.
Suite2
North East, MD 21901
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3579 | Medicaid | MD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3597 | MD | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1679029243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2057 PULASKY HWY.",
"address_2": "SUITE2",
"city": "NORTH EAST",
"state": "MD",
"postal_code": "21901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2057 PULASKY HWY.",
"address_2": "SUITE 2",
"city": "NORTH EAST",
"state": "MD",
"postal_code": "21901",
"telephone_number": "410-287-2323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "BRENDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-01",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MD",
"license": "3597",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3579",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in North East, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.