Mishpacha Dental

Primary specialty

DentistTaxonomy code 122300000X

License

4961 Issued in MD

Legal business name

MISHPACHA DENTAL

Practice address

3635 Old Court Rd
Ste. 510
Pikesville, MD 21208-3915

Phone

(410) 484-2717

Fax

(443) 519-4078

NPI assigned

Nov 6, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Larry Bank, DDS

Title

Dentist

Phone

(410) 484-2717

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1912303769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 OLD COURT RD",
            "address_2": "STE. 510",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212083915",
            "fax_number": "443-519-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 OLD COURT RD",
            "address_2": "STE. 510",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212083915",
            "telephone_number": "410-484-2717",
            "fax_number": "443-519-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISHPACHA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "BANK",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "410-484-2717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "4961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Pikesville, MD
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.