Active NPI
Mina Baradaran Alizadeh, D.D.S.
- Dentist
- Glen Arm, MD
National Provider Identifier
1881070530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15731
- Practice address
- 24 Gunpowder Rd
Glen Arm, MD 21057-9460 - Phone
- (410) 375-6685
- NPI assigned
- Aug 5, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 15731 | MD | Primary |
Addresses
Primary practice location
24 Gunpowder Rd
Glen Arm, MD 21057-9460
Mailing address
24 Gunpowder Rd
Glen Arm, MD 21057-9460
Phone (410) 375-6685
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 |
|---|---|---|---|
| 15731 | MD | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438732800000",
"number": "1881070530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 GUNPOWDER RD",
"city": "GLEN ARM",
"state": "MD",
"postal_code": "210579460",
"telephone_number": "410-375-6685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 GUNPOWDER RD",
"city": "GLEN ARM",
"state": "MD",
"postal_code": "210579460",
"telephone_number": "410-375-6685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALIZADEH",
"first_name": "MINA",
"middle_name": "BARADARAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-05",
"last_updated": "2015-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "15731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Arm, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.