Provider Demographics
NPI:1407740442
Name:LINDEMUTH, PAUL EDWARD
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:EDWARD
Last Name:LINDEMUTH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 BOSTON ST APT 427
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4853
Mailing Address - Country:US
Mailing Address - Phone:907-317-5425
Mailing Address - Fax:
Practice Address - Street 1:1501 S CLINTON ST STE 335
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-5753
Practice Address - Country:US
Practice Address - Phone:410-237-0174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MD188911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program