Individual provider Active NPI

Tamara Miles-Dulan, DDS

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1700904752
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11482 Issued in MD
Practice address
6058 Rossville Blvd
108
Baltimore, MD 21221-3158
Phone
(410) 391-3801
Fax
(410) 391-7906
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11482 MD Primary

Addresses

Primary practice location

6058 Rossville Blvd
108
Baltimore, MD 21221-3158

Mailing address

6058 Rossville Blvd
108
Baltimore, MD 21221-3158
Phone (410) 391-3801

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
11482MDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1700904752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6058 ROSSVILLE BLVD",
            "address_2": "108",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212213158",
            "telephone_number": "410-391-3801",
            "fax_number": "410-391-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6058 ROSSVILLE BLVD",
            "address_2": "108",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212213158",
            "telephone_number": "410-391-3801",
            "fax_number": "410-391-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES-DULAN",
        "first_name": "TAMARA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.