Active NPI
Manali A Vaidya, DDS
- General Practice Dentistry
- Baltimore, MD
National Provider Identifier
1992298228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 16482
- Practice address
- 4510 Edmondson Ave
Baltimore, MD 21229 - Phone
- (410) 233-5777
- NPI assigned
- Jun 12, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MD | ||
| General Practice Dentistry | 1223G0001X | 16482 | MD | Primary |
Addresses
Primary practice location
4510 Edmondson Ave
Baltimore, MD 21229
Mailing address
Dental Dreams LLC, C/O Marina Miller
350 N. Clark Street, 6TH Floor
Chicago, IL 60654
Phone (312) 274-4524
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 |
|---|---|---|---|
| 16482 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Dreams LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Bourbonnais, IL
- NPI 1083092670
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530403200000",
"number": "1992298228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DENTAL DREAMS LLC, C/O MARINA MILLER",
"address_2": "350 N. CLARK STREET, 6TH FLOOR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60654",
"telephone_number": "312-274-4524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4510 EDMONDSON AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21229",
"telephone_number": "410-233-5777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAIDYA",
"first_name": "MANALI",
"middle_name": "A",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-12",
"last_updated": "2018-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MD",
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "16482",
"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 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.