NPIMap

Organization Active NPI

Neibauer Dental Care, PC

Doing business as Neibauer Dental Care - Crofton

  • General Practice Dentistry
  • Gambrills, MD
National Provider Identifier
1972870509
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NEIBAUER DENTAL CARE, PC
Doing business as
Neibauer Dental Care - Crofton
Practice address
1166 State Route 3 S
Suite 211
Gambrills, MD 21054-1767
Phone
(410) 721-2409
Fax
(410) 451-0237
NPI assigned
Nov 28, 2011
Last updated
Nov 28, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
NEIBAUER DENTAL CARE, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Authorized official

Name
Pam Hardiek
Title
Insurance / Credentialing
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1166 State Route 3 S
Suite 211
Gambrills, MD 21054-1767

Mailing address

1166 State Route 3 S
Suite 211
Gambrills, MD 21054-1767
Phone (410) 721-2409

Other names 1

  • Neibauer Dental Care - Crofton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Neibauer Dental Care PC30 organizations share this tax ID, including this one
Part of
Neibauer Dental Care PC

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Locations

1166 State Route 3 S
Ste 211
Gambrills, MD 21054
Phone (410) 721-2409

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1972870509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 STATE ROUTE 3 S",
            "address_2": "SUITE 211",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541767",
            "telephone_number": "410-721-2409",
            "fax_number": "410-451-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 STATE ROUTE 3 S",
            "address_2": "SUITE 211",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541767",
            "telephone_number": "410-721-2409",
            "fax_number": "410-451-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIBAUER DENTAL CARE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEIBAUER DENTAL CARE, PC",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "HARDIEK",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "INSURANCE / CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neibauer Dental Care - Crofton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gambrills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.