Provider Demographics
NPI:1386931517
Name:JAMESON, ERLINDA EMBUSCADO (DDS)
Entity type:Individual
Prefix:DR
First Name:ERLINDA
Middle Name:EMBUSCADO
Last Name:JAMESON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ERLINDA
Other - Middle Name:EVANGELISTA
Other - Last Name:EMBUSCADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:731 DEEPDENE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2153
Mailing Address - Country:US
Mailing Address - Phone:410-323-3990
Mailing Address - Fax:410-323-2246
Practice Address - Street 1:731 DEEPDENE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2153
Practice Address - Country:US
Practice Address - Phone:410-323-3990
Practice Address - Fax:410-323-2246
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD152071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice