ANDREA PELLOM (NPI# 1942670799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942670799 |
| Entity Type | Individual |
| Full Name | ANDREA PELLOM |
| Practice Address |
3319 W Belvedere Ave Baltimore MD 21215-5143 |
| Mailing Address |
6005 Belle Grove Rd Baltimore MD 21225-3261 |
| Practice Telephone | 4105427800 |
| Practice Fax Number | 4105422039 |
| Mailing Telephone | 4109198278 |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2015-10-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 7148 | MD | Dental Providers |
| Street Address |
3319 W BELVEDERE AVE |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21215-5143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386620649 | Northwest Baltimore Youth Services, Inc. | Voluntary or Charitable | 3319 W Belvedere Ave, Baltimore, MD 21215-5103 | 2005-12-19 |
| 1194281295 | Jessica Angel Thomas | Counselor | 3319 W Belvedere Ave, Baltimore, MD 21215-5143 | 2019-02-13 |
| 1225586639 | William Wasson | Social Worker | 3319 W Belvedere Ave, Attn: Credentialing, Baltimore, MD 21215-5143 | 2016-09-14 |
| 1295100568 | Treatment Resources for Youth, Inc. | Clinic/Center | 3319 W Belvedere Ave, Baltimore, MD 21215-5143 | 2015-12-11 |
| 1194950782 | Tyronnia Aarone Jones | Registered Nurse | 3319 W Belvedere Ave, Baltimore, MD 21215-5143 | 2009-05-26 |
| 1821234592 | Heinz Nagel | Pediatrics | 3319 W Belvedere Ave, Baltimore, MD 21215-5143 | 2008-12-30 |
| 1619187218 | Parkwest Health Systems, Inc | Pharmacy | 3319 W Belvedere Ave, Baltimore, MD 21215-5103 | 2007-05-23 |
| 1124242920 | Parkwest Health Systems Inc | Clinic/Center | 3319 W Belvedere Ave, Baltimore, MD 21215-5103 | 2007-04-12 |
| 1306980073 | Tanzania Vicino | Obstetrics & Gynecology | 3319 W Belvedere Ave, Baltimore, MD 21215-5103 | 2007-02-16 |
| 1306992714 | Lawrence Bernard Johnson | Pediatrics | 3319 W Belvedere Ave, Baltimore, MD 21215-5103 | 2007-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639736796 | Talal Abalkhail | Student in an Organized Health Care Education/Training Program | 2401 W. Belvedere Avenue, Baltimore, Md 21215, Baltimore, MD 21215 | 2019-05-23 |
| 1235795410 | Bilal Khan | Student in an Organized Health Care Education/Training Program | 2041 West Belvedere Avenue, Balitmore, MD 21215 | 2019-05-14 |
| 1669036067 | Nasir M Alhamdan | Student in an Organized Health Care Education/Training Program | Of Baltimore, 2401 West Belvedere Ave, Baltimore, MD 21215 | 2019-05-01 |
| 1851863971 | Brittany Michelle O'neill | Specialist/Technologist | Hearing and Speech Agency, 5900 Metro Drive, Baltimore, MD 21215 | 2018-12-31 |
| 1881164432 | Emily Gamma | Social Worker | 4810 Seton Drive, Baltimore, MD 21215 | 2018-11-27 |
| 1518440478 | Benson Baby | Physical Therapist | 2525west Belveder Ave, Baltimore, MD 21215 | 2018-09-07 |
| 1609360817 | Bonnie Kahler | Clinical Nurse Specialist | 2401 Belvedere Avenue, Baltimore, MD 21215 | 2018-06-20 |
| 1932693843 | Kelley Monica Cohill | Social Worker | Sinai Hospital, Department of Psychiatry, 2440 Cylburn Ave., Baltimore, MD 21215 | 2018-06-15 |
| 1497245609 | Kimberly Beth Koerner | Social Worker | 2401 W. Belvedere Avenue, Baltimore, MD 21215 | 2018-05-14 |
| 1184113078 | Mary Jo Kozel | Registered Nurse | 2401 West Belvedere, Baltimore, MD 21215 | 2018-05-07 |
| Find all providers in zip 21215 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033746185 | Cynthia Ann Finfrock | Dental Hygienist | 650 W Baltimore St Rm 2202, Baltimore, MD 21201-1510 | 2020-03-26 |
| 1730557786 | Allene I Mcclary | Dental Hygienist | 4505 Scarlet Oak Ln, Baltimore, MD 21229-2485 | 2015-09-08 |
| 1669030623 | Sharonda Sparks | Dental Hygienist | 5632 The Alameda, Baltimore, MD 21239-2737 | 2019-06-04 |
| 1649749763 | Christine Benato | Dental Hygienist | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2018-11-19 |
| 1003153735 | Sandra King | Dental Hygienist | 600 N Wolfe St, Blalock 266, Baltimore, MD 21287-0005 | 2013-01-15 |
| 1679842728 | Anuja Wagh | Dental Hygienist | 650 W Baltimore St, Room 4214, 4th Floor, Baltimore, MD 21201-1510 | 2011-12-19 |
| 1043501414 | Liguori Anne Tewes | Dental Hygienist | 650 W Baltimore St, Baltimore, MD 21201-1510 | 2011-04-20 |
| 1578853305 | Baltimore College of Dental Surgery | Dental Hygienist | 650 W Baltimore St, Baltimore, MD 21201-1510 | 2011-04-13 |
| 1548572316 | Michele Loretta Alford | Dental Hygienist | 1501 Division St, Baltimore, MD 21217-3121 | 2010-07-09 |
| 1639492168 | Orthella Gray-butler | Dental Hygienist | 1501 Division St, Baltimore, MD 21217-3121 | 2010-03-11 |
| 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.