Active NPI
Melvin Jay Weissburg, D.M.D
- Endodontics
- Severna Park, MD
National Provider Identifier
1760415616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 6860
- Practice address
- 22 Truck House Rd Ste 100
Severna Park, MD 21146-2728 - Phone
- (443) 816-6363
- Fax
- (410) 647-1947
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 6860 | MD | Primary |
Addresses
Primary practice location
22 Truck House Rd Ste 100
Severna Park, MD 21146-2728
Mailing address
22 Truck House Rd Ste 100
Severna Park, MD 21146-2728
Phone (434) 816-6363
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 |
|---|---|---|---|
| 6860 | MD | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719273600000",
"number": "1760415616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 TRUCK HOUSE RD STE 100",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211462728",
"telephone_number": "434-816-6363",
"fax_number": "410-647-1947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 TRUCK HOUSE RD STE 100",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211462728",
"telephone_number": "443-816-6363",
"fax_number": "410-647-1947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISSBURG",
"first_name": "MELVIN",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2024-06-25",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MD",
"license": "6860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severna Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.