Yeremi A Canizales, D.D.S.
Individual provider Active NPI Dentist · Belcamp, MD
NPI 1790079697 · NPPES record last updated Jun 8, 2011
Key facts
- NPI
- 1790079697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 14933 (MD)
- Practice address
- 111 Bata Blvd Ste D
Suite D
Belcamp, MD 21017-1427 - Phone
- (410) 939-3343
- Fax
- (410) 939-9049
- NPI assigned
- Jun 8, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14933 | MD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yeremi a Canizales DDS P a | Current |
Accepting new patients | |
| Neelu S Milak | Dentist | Past | Accepting new patients |
Locations
572 Ritchie Hwy
Ste F
Severna Park, MD 21146
Phone (410) 647-4094
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14933 | MD | Yes |
Addresses
Primary practice location
111 Bata Blvd Ste D
Suite D
Belcamp, MD 21017-1427
Mailing address
111 Bata Blvd Ste D
Suite D
Belcamp, MD 21017-1427
Phone (410) 939-3343
Other providers in Belcamp, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.