NPIMap

Organization Active NPI

Eyedentity,LLC

  • Optometrist
  • Bel Air, MD
National Provider Identifier
1871812784
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA 1449 Issued in MD
Legal business name
EYEDENTITY,LLC
Practice address
223 Brierhill Dr Ste C
Bel Air, MD 21015-4948
Phone
(410) 420-3933
Fax
(410) 420-6399
NPI assigned
May 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michelle J Centi, O.D.
Title
Owner
Phone
(410) 420-3933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TA 1449 MD Primary

Addresses

Primary practice location

223 Brierhill Dr Ste C
Bel Air, MD 21015-4948

Mailing address

223 Brierhill Dr Ste C
Bel Air, MD 21015-4948
Phone (410) 420-3933

National Provider Directory

National Provider Directory

Locations

223 Brierhill Dr
Ste C
Bel Air, MD 21015
Phone (410) 420-3933

NPI Registry JSON

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1871812784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 BRIERHILL DR STE C",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210154948",
            "telephone_number": "410-420-3933",
            "fax_number": "410-420-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 BRIERHILL DR STE C",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210154948",
            "telephone_number": "410-420-3933",
            "fax_number": "410-420-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEDENTITY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-18",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "CENTI",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-420-3933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA 1449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.