Evan N Padousis, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12359 Issued in MD

Practice address

6304 Kenwood Ave
Suite 5
Baltimore, MD 21237

Phone

(410) 866-6660

Fax

(410) 866-1557

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Padousis & Kaminaris DDS PA

  • Dentist
  • Baltimore, MD
  • NPI 1881614121
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699795930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6304 KENWOOD AVE",
            "address_2": "SUITE 5",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21237",
            "telephone_number": "410-866-6660",
            "fax_number": "410-866-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6304 KENWOOD AVE",
            "address_2": "SUITE 5",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21237",
            "telephone_number": "410-866-6660",
            "fax_number": "410-866-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADOUSIS",
        "first_name": "EVAN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "12359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "19584",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "588871",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO",
            "identifier": "103021",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "4976",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hope Padilla
• Santiago Luis Padilla, M.D.
• James Harrison Padley, MD
• Sriram Padmanabhan, M.D.
• Padousis & Kaminaris DDS PA
• Penny Padousis, CRNP
• William Michael Padovano, MD
• Demetria Petros Padussis, MS, CCC-SLP
• Laura Juliana Paez Zamora, M.D.
• Zualbi Pagan Cruz

• Dentist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.