Rudolph E. Klima Jr., D.D.S P.A.
Individual provider Active NPI General Practice Dentistry · Hampstead, MD
NPI 1992803407 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992803407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 9905 (MD)
- Practice address
- 4519 Lower Beckleysville Rd
Hampstead, MD 21074-2613 - Phone
- (410) 239-9724
- Fax
- (410) 239-1468
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150716000299 | MD | Order and Referring Only - Dentist |
6507179843 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rudolph E. Klima Jr. D.D.S., P.a. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9905 | MD | Yes |
Addresses
Primary practice location
4519 Lower Beckleysville Rd
Hampstead, MD 21074-2613
Mailing address
4519 Lower Beckleysville Rd
Hampstead, MD 21074-2613
Phone (410) 239-9724
Other providers in Hampstead, MD
- Charles Richard Johns Jr.
- Mackenzie Keeney
- Thomas P Kenney
- Kindred Treatment Center
- Carl Kirsch
- Deanna Kopf
- Jessica Little Kovolenko
- Mary Beth Krauss
- Lage Lactation LLC
- Morgan Lage
All providers in Hampstead, MD · General Practice Dentistry in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.