Bayside Dental Associates, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7389 Issued in MD

Legal business name

BAYSIDE DENTAL ASSOCIATES, PA

Practice address

208 Saint Claire PL
Stevensville, MD 21666-2170

Phone

(410) 643-8110

Fax

(410) 643-5311

NPI assigned

Jul 25, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Walter Allen Gillin, DDSNPI 1710152681

Title

Ceo

Phone

(410) 643-8110

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Walter Allen Gillin, DDS

  • General Practice Dentistry
  • Stevensville, MD
  • NPI 1710152681
  NPD (past) Authorized official

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343174400000",
    "number": "1972859189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 SAINT CLAIRE PL",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216662170",
            "telephone_number": "410-643-8110",
            "fax_number": "410-643-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 SAINT CLAIRE PL",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216662170",
            "telephone_number": "410-643-8110",
            "fax_number": "410-643-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE DENTAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A",
        "authorized_official_last_name": "GILLIN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-643-8110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "7389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah E Aufderheide, D.D.S.
• Sunitha Baareddy Veluri
• Baxter Home Health, LLC
• Bay Area Pediatrics, LLC
• Bay Surgery Centers - Kent Island
• Bayside Physical Therapy & Sports Rehabilitation Limited Partnership
• Bayside Physical Therapy and Rehabilitation, Inc
• Bellwether Therapy LLC
• Amy Louise Gibbs Bennett, LCPC, NCC
• Charles N. Bethmann, P.A.-C

• General Practice Dentistry in Stevensville, MD
• Providers in Stevensville, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; 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.