Individual provider Active NPI

Michael H Allen, DMD

  • General Practice Dentistry
  • Severna Park, MD
National Provider Identifier
1861548810
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4725 Issued in MD
Practice address
517 Benfield Rd
Suite 204
Severna Park, MD 21146
Phone
(410) 647-7050
Fax
(410) 647-8920
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 4725 MD Primary

Addresses

Primary practice location

517 Benfield Rd
Suite 204
Severna Park, MD 21146

Mailing address

517 Benfield Rd
Suite 204
Severna Park, MD 21146
Phone (410) 647-7050

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
4725MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mitra Madani, D.D.S, LLC PastSince Mar 4, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861548810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 BENFIELD RD",
            "address_2": "SUITE 204",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "21146",
            "telephone_number": "410-647-7050",
            "fax_number": "410-647-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 BENFIELD RD",
            "address_2": "SUITE 204",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "21146",
            "telephone_number": "410-647-7050",
            "fax_number": "410-647-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "4725",
            "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 Jul 8, 2007; 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.