DR. PEDAR BRADEN DIDRIKSEN (NPI# 1093890436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093890436 |
| Entity Type | Individual |
| Full Name | DR. PEDAR BRADEN DIDRIKSEN |
| Credential | DDS |
| Practice Address |
11310 Manklin Creek Rd Unit 5 Berlin MD 21811-4013 |
| Mailing Address |
907 Rainbow Dr Cedar Falls IA 50613 |
| Practice Telephone | 4102082900 |
| Practice Fax Number | 4102083285 |
| Mailing Telephone | 3192777441 |
| Mailing Fax Number | 3195530607 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2019-03-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 7825 | IA | Dental Providers |
| Street Address |
11310 MANKLIN CREEK RD UNIT 5 |
| City | BERLIN |
| State | MD |
| Zip Code | 21811-4013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366912909 | Kathleen Cathell | Speech-Language Pathologist | 11187 Racetrack Rd, Berlin, MD 21811 | 2018-11-27 |
| 1033613336 | Kimberly Rose Richardson | Registered Nurse | Atlantic General Hospital, 9733 Healthway Dr, Berlin, MD 21811 | 2018-03-21 |
| 1780108514 | Jayme Sroka Mahoney | Marriage & Family Therapist | 124 N. Main St. Ste. C, Berlin, MD 21811 | 2017-08-02 |
| 1013332543 | Ray Charles Lockamy Jr. | Behavior Technician | 10514 Racetrack Rd Ste G, Berlin, MD 21811 | 2014-02-20 |
| 1972845121 | Timothy Pearson | Dermatology | 9948 N. Main St., Berlin, MD 21811 | 2013-03-25 |
| 1710248315 | Jaime Farrell Coates | Counselor | 378 Schooner Ln, Berlin, MD 21811 | 2012-05-31 |
| 1902185697 | Lee Ahlstrom | Pharmacist | 11307 Manklin Creek Rd, Berlin, MD 21811 | 2011-08-11 |
| 1780987677 | Worcester County Health Department | Public Health or Welfare | 107 Williams Street, Worcester County Health Department Dental Center, Berlin, MD 21811 | 2010-12-15 |
| 1942511563 | Corey Lee Smith | Dentist | 11204 Racetrack Rd Ste 102, Berlin, MD 21811 | 2010-06-29 |
| 1255656062 | Sarah Mae Brown | Pharmacist | Apple Discount Drugs 314 Franklin Avenue, Berlin, MD 21811 | 2010-04-05 |
| Find all providers in zip 21811 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013365303 | Jose Luis Aviles | Dentist | 228 Church St, Berlin, NH 03570-2129 | 2016-05-27 |
| 1841629045 | Swetha Budda | Dentist | 175 Berlin Cross Keys Rd, Suite103, Berlin, NJ 08009-9263 | 2013-11-07 |
| 1053620674 | Richard Nazer | Dentist | 339 North Route 73, Berlin, NJ 08009 | 2010-09-30 |
| 1376789479 | John Franklin Knight | Dentist | 314 Franklin Ave Ste 305, Berlin, MD 21811-1238 | 2008-12-20 |
| 1831394857 | Morton Aaron Winner | Dentist | 22 Brandywine Drive, Berlin, NJ 08009-2229 | 2007-06-19 |
| 1003019837 | Coos County Family Health Services | Dentist | 73 Main Street, Berlin, NH 03570 | 2007-06-08 |
| 1316017908 | Arliene M Pearson | Dentist | 395 Paine Turn Pike North, Berlin, VT 05602 | 2006-11-09 |
| 1336245414 | Amy Lynn Golden | Dentist | 19 Harker Ave, Berlin, NJ 08009-2331 | 2006-09-15 |
| 1619083698 | Gary A. Eggert | Dentist | 169 Memorial Dr, Berlin, WI 54923-1241 | 2006-08-22 |
| 1699725333 | Kurt Alan Zemke | Dentist | 280 South Church St, Berlin, WI 54923 | 2006-05-11 |
| Find all providers in BERLIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.