Individual provider Active NPI

Paul Joseph Vidziunas, D.D.S.

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1821221367
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8250 Issued in MD
Practice address
2100 Eastern Blvd
Baltimore, MD 21220-4704
Phone
(410) 686-4646
Fax
(410) 686-4896
NPI assigned
Sep 1, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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 8250 MD Primary

Addresses

Primary practice location

2100 Eastern Blvd
Baltimore, MD 21220-4704

Mailing address

2100 Eastern Blvd
Baltimore, MD 21220-4704
Phone (410) 686-4646

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
8250MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ned S Greenberg DDS PA Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252886400000",
    "number": "1821221367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 EASTERN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212204704",
            "telephone_number": "410-686-4646",
            "fax_number": "410-686-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 EASTERN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212204704",
            "telephone_number": "410-686-4646",
            "fax_number": "410-686-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDZIUNAS",
        "first_name": "PAUL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-01",
        "last_updated": "2009-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "8250",
            "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 14, 2009; 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.