Active NPI
Alan Selig Eidensohn, D.M.D.
- General Practice Dentistry
- Baltimore, MD
National Provider Identifier
1912915216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7739
- Practice address
- 3322 Frederick Ave
Baltimore, MD 21229-3810 - Phone
- (410) 566-2080
- Fax
- (410) 566-6379
- NPI assigned
- Aug 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7739 | MD | Primary |
Addresses
Primary practice location
3322 Frederick Ave
Baltimore, MD 21229-3810
Mailing address
3322 Frederick Ave
Baltimore, MD 21229-3810
Phone (410) 566-2080
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 |
|---|---|---|---|
| 7739 | MD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian W. Robertson DDS PA | Past | Accepting new patients | |
| Sherman H. Deveas III, DDS P.a. | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Baltimore, MD
- NPI 1497136949
-
- General Practice Dentistry
- Baltimore, MD
- NPI 1760528004
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912915216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3322 FREDERICK AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212293810",
"telephone_number": "410-566-2080",
"fax_number": "410-566-6379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3322 FREDERICK AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212293810",
"telephone_number": "410-566-2080",
"fax_number": "410-566-6379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EIDENSOHN",
"first_name": "ALAN",
"middle_name": "SELIG",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "7739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.