DR. RICHARD MARK IMBACH (NPI# 1790920759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790920759 |
| Entity Type | Individual |
| Full Name | DR. RICHARD MARK IMBACH |
| Credential | DDS |
| Practice Address |
4809 Leeds Ave Baltimore MD 21227 |
| Practice Telephone | 4102421112 |
| Practice Fax Number | 4104189579 |
| Mailing Telephone | 4102421112 |
| Mailing Fax Number | 4104189579 |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2008-12-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 06979 | MD | Dental Providers |
| Street Address |
4809 LEEDS AVE |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528622024 | Kim Conaway | Counselor | Regenerations Counseling Services, 1421 S. Canton Street, Baltimore, MD 21227 | 2019-04-30 |
| 1861974891 | Joan Lynn Indilisano | Occupational Therapist | 3320 Benson Avenue, Baltimore, MD 21227 | 2018-09-06 |
| 1821593161 | Institute for Dermatopathology, Inc. | Clinical Medical Laboratory | 1901 Sulphur Spring Rd Ste A, Baltimore, MD 21227 | 2018-03-28 |
| 1447779699 | Aja Williams | Registered Nurse | 3902 Annapolis Rd., Halethorpe, MD 21227 | 2017-09-19 |
| 1588190748 | Mentor-maryland | Community/Behavioral Health | 1540 Caton Center Drive, Halethorpe, MD 21227 | 2017-05-10 |
| 1083084180 | Institute for Family Centered Services | Community/Behavioral Health | 1540 Caton Centered Drive, Suite F, Baltimore, MD 21227 | 2015-10-01 |
| 1174913677 | Wye Oak Clinic, Inc. | Marriage & Family Therapist | 1937 Lansdowne Rd, Halethorpe, MD 21227 | 2015-02-04 |
| 1588938237 | Ahmein Watson | Social Worker | 1504 Joh Ave Ste 120, Baltimore, MD 21227 | 2012-02-28 |
| 1336442656 | Norah Orise Osian | Pharmacist | Rite Aid Pharmacy, 1400 Sulphur Spring Rd, Baltimore, MD 21227 | 2010-12-08 |
| 1366759623 | Een J Lee | Pharmacist | 1400 Sulphurspring Rd, Baltimore, MD 21227 | 2010-09-08 |
| Find all providers in zip 21227 | ||||
| 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 |
|---|---|---|---|---|
| 1750999736 | Kyung Min Shin | Dentist | 11 S Eutaw St Apt 1609, Baltimore, MD 21201-1638 | 2020-07-16 |
| 1649897935 | Cory Kyser | Dentist | 1900 E Northern Pkwy Ste 103, Baltimore, MD 21239-2109 | 2020-07-02 |
| 1841814845 | Michael Listhaus | Dentist | 650 W Baltimore St Rm 2204, Baltimore, MD 21201-1510 | 2020-06-04 |
| 1598325904 | Chelsea Merritt | Dentist | 2 N Charles St Ste 130, Baltimore, MD 21201-3715 | 2019-06-18 |
| 1699235036 | Alyssa M Dierkes | Dentist | 10 Light St Unit 1002, Baltimore, MD 21202-1476 | 2019-03-21 |
| 1841777323 | Nikta Pashai | Dentist | 4660 Wilkens Ave Ste 301, Baltimore, MD 21229-4845 | 2018-07-26 |
| 1003306671 | Bk Faithful Enterprises Consulting, LLC | Dentist | 3120 Lord Baltimore Dr Ste 100, Baltimore, MD 21244 | 2018-05-18 |
| 1851814065 | Frederico Canato Martinho | Dentist | 650 W Baltimore St Rm 6258, Baltimore, MD 21201-1510 | 2017-07-19 |
| 1578085593 | Rabia Eltaf | Dentist | 1010 S Northpoint Rd, Baltimore, MD 21224-3307 | 2017-07-11 |
| 1699297838 | Smile Dental, LLC | Dentist | 535 Dundalk Ave Ste 2, Baltimore, MD 21224-2903 | 2017-07-10 |
| Find all providers in BALTIMORE | ||||
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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.