Active NPI
Thu Viet Mai, DDS
- Periodontics
- Bel Air, MD
National Provider Identifier
1891073581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 15634
- Practice address
- 2014 S Tollgate Rd Ste 108
Bel Air, MD 21015-5906 - Phone
- (410) 569-2243
- NPI assigned
- Jul 28, 2011
- Last updated
- Dec 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 60631 | CA | |
| Periodontics | 1223P0300X | 15634 | MD | Primary |
Addresses
Primary practice location
2014 S Tollgate Rd Ste 108
Bel Air, MD 21015-5906
Mailing address
2014 S Tollgate Rd Ste 108
Bel Air, MD 21015-5906
Phone (410) 569-2243
Other names 1
- Dr. Thu M Versteegh
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 |
|---|---|---|---|
| 15634 | MD | MD | Physical Therapist |
| 60631 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thu Viet Mai DDS LLC | Periodontics | Current | Accepting new patients |
Locations
2014 S Tollgate Rd
Ste 108
Bel Air, MD 21015
Phone (410) 569-2243
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": "1311811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609200000000",
"number": "1891073581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2014 S TOLLGATE RD STE 108",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210155906",
"telephone_number": "410-569-2243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2014 S TOLLGATE RD STE 108",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210155906",
"telephone_number": "410-569-2243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAI",
"first_name": "THU",
"middle_name": "VIET",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-28",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "60631",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MD",
"license": "15634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "THU",
"last_name": "VERSTEEGH",
"middle_name": "M",
"prefix": "DR.",
"credential": "DDS",
"code": "2",
"type": "Professional Name"
}
]
}
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 Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.