Active NPI
Vilija Mickute, DDS
- Dentist
- Hampstead, MD
National Provider Identifier
1730446253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14886
- Practice address
- 2113 Hanover Pike
Hampstead, MD 21074-1319 - Phone
- (410) 374-5200
- NPI assigned
- Apr 22, 2012
- Last updated
- Apr 4, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 14886 | MD | Primary |
Addresses
Primary practice location
2113 Hanover Pike
Hampstead, MD 21074-1319
Mailing address
2113 Hanover Pike
Hampstead, MD 21074-1319
Phone (410) 374-5200
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160113002871 | MD | Order and Referring Only - Dentist | 9638471204 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14886 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428105600000",
"number": "1730446253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2113 HANOVER PIKE",
"city": "HAMPSTEAD",
"state": "MD",
"postal_code": "210741319",
"telephone_number": "410-374-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2113 HANOVER PIKE",
"city": "HAMPSTEAD",
"state": "MD",
"postal_code": "210741319",
"telephone_number": "410-374-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICKUTE",
"first_name": "VILIJA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-22",
"last_updated": "2015-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "14886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hampstead, MD
- Susan Garfield McIntosh, M.AC.,L.AC.
- Brooke Elizabeth Meckley, MS
- Meredith Menikheim, PHARMD
- Eugene Duston Mersinger, DDS
- Christina L Meyer, LMSW
- Elizabeth R Miller, RD, LDN
- MNR Industries LLC (ExpressCare of Hampstead)
- Terrence Patrick Moore, LMSW
- Therese Moran Conlon
- Robert Bradley Mountcastle, ATC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2015; 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.