Samuel Charles Havrilak, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6146 Issued in MD

Practice address

2419 E Joppa Rd
Baltimore, MD 21234

Phone

(410) 668-5035

Fax

(410) 668-5036

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Robinson Dental LLC

  • General Practice Dentistry
  • Parkville, MD
  • NPI 1518616564
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982714994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 E JOPPA RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21234",
            "telephone_number": "410-668-5035",
            "fax_number": "410-668-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 E JOPPA RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21234",
            "telephone_number": "410-668-5035",
            "fax_number": "410-668-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVRILAK",
        "first_name": "SAMUEL",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "6146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND DENTAL PLAN",
            "identifier": "3154",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haven Nursing Home, Inc
• Haven Nursing Home, Inc
• Havenroot Therapy and Wellness
• Hana Lei Haver, MD
• Dzmitry Haviazheu
• Hazem Hawasli, M.D.
• Kegham Hawatian
• Tabitha Hawbaker
• Armani Minasian Hawes
• Cindy Jean Hawk, P.A.-C

• General Practice Dentistry in Baltimore, MD
• Providers in Baltimore, 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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.