Individual provider Active NPI

Dustin Forrester Sentz, PSY.D.

  • Clinical Psychologist
  • Towson, MD
National Provider Identifier
1912039157
Registry record updated Sep 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
04247 Issued in MD
Practice address
1107 Kenilworth Dr Ste 208
Towson, MD 21204
Phone
(410) 370-0299
NPI assigned
Mar 12, 2007
Last updated
Sep 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 04247 MD Primary

Addresses

Primary practice location

1107 Kenilworth Dr Ste 208
Towson, MD 21204

Mailing address

1107 Kenilworth Dr Ste 208
Towson, MD 21204-2136
Phone (410) 370-0299

Other practice location 1

2360 W Joppa Rd
Suite 318
Lutherville, MD 21093-4624
Phone (410) 825-3646

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070806000227 MD Practitioner - Clinical Psychologist 9537250519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1107 Kenilworth Dr
Suite 208
Towson, MD 21204-2136
Phone (410) 370-0299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04247MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dustin Sentz LLC Clinical CurrentSince Jan 1, 2018 Accepting new patients

Locations

2360 W Joppa Rd
Ste 318
Luthvle Timon, MD 21093
Phone (410) 370-0299

1107 Kenilworth Dr
Ste 208
Towson, MD 21204
Phone (410) 370-0299

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535932800000",
    "number": "1912039157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 KENILWORTH DR STE 208",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042136",
            "telephone_number": "410-370-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 KENILWORTH DR STE 208",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "21204",
            "telephone_number": "410-370-0299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2360 W Joppa Rd",
            "address_2": "Suite 318",
            "address_purpose": "LOCATION",
            "city": "Lutherville",
            "state": "MD",
            "postal_code": "210934624",
            "country_code": "US",
            "telephone_number": "410-825-3646",
            "fax_number": "410-825-3649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SENTZ",
        "first_name": "DUSTIN",
        "middle_name": "FORRESTER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2018-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.