Individual provider Active NPI

Lawrence Abraham Amsterdam, D.M.D.

  • General Practice Dentistry
  • Essex, MD
National Provider Identifier
1891858080
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
06742 Issued in MD
Practice address
1528 Country Ridge LN
Essex, MD 21221-3906
Phone
(410) 574-1555
Fax
(410) 574-8483
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
Yes

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 06742 MD Primary

Addresses

Primary practice location

1528 Country Ridge LN
Essex, MD 21221-3906

Mailing address

1528 Country Ridge LN
Essex, MD 21221-3906
Phone (410) 574-1555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150602000038 MD Order and Referring Only - DentistPractitioner - Dentist 9133440241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06742MDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891858080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 COUNTRY RIDGE LN",
            "city": "ESSEX",
            "state": "MD",
            "postal_code": "212213906",
            "telephone_number": "410-574-1555",
            "fax_number": "410-574-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 COUNTRY RIDGE LN",
            "city": "ESSEX",
            "state": "MD",
            "postal_code": "212213906",
            "telephone_number": "410-574-1555",
            "fax_number": "410-574-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMSTERDAM",
        "first_name": "LAWRENCE",
        "middle_name": "ABRAHAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "06742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex, MD

Sources for this page

Verify at the official NPI Registry.