NPIMap

Organization Active NPI

Thomas B. Fahey Jr. DDS, PA

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1710043138
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4809 Issued in MD
Legal business name
THOMAS B. FAHEY JR. DDS, PA
Practice address
6601 York Rd
Baltimore, MD 21212-2026
Phone
(410) 377-2000
Fax
(410) 377-2145
NPI assigned
Dec 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas B Fahey Jr., DDSNPI 1255497673
Title
Owner
Phone
(410) 377-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4809 MD Primary

Addresses

Primary practice location

6601 York Rd
Baltimore, MD 21212-2026

Mailing address

107 Shetland Hills Dr
Lutherville, MD 21093-5843
Phone (410) 828-0067

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710043138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 SHETLAND HILLS DR",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935843",
            "telephone_number": "410-828-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212122026",
            "telephone_number": "410-377-2000",
            "fax_number": "410-377-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS B. FAHEY JR. DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAHEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-377-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "4809",
            "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 Aug 22, 2020; 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.