Provider Demographics
NPI:1427883149
Name:DENTAL SPOT, LLC
Entity type:Organization
Organization Name:DENTAL SPOT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NOURMAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-762-1470
Mailing Address - Street 1:6510 GARDENWICK RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2538
Mailing Address - Country:US
Mailing Address - Phone:443-762-1470
Mailing Address - Fax:
Practice Address - Street 1:6210 PARK HEIGHTS AVE UNIT 104
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-3626
Practice Address - Country:US
Practice Address - Phone:443-583-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice