Provider Demographics
NPI:1225533763
Name:JOSHUA P WEINTRAUB DDS,P.A.
Entity Type:Organization
Organization Name:JOSHUA P WEINTRAUB DDS,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT DESK COORDINATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-764-8526
Mailing Address - Street 1:10407 STEVENSON RD
Mailing Address - Street 2:
Mailing Address - City:STEVENSON
Mailing Address - State:MD
Mailing Address - Zip Code:21153-0600
Mailing Address - Country:US
Mailing Address - Phone:410-764-8500
Mailing Address - Fax:410-764-8504
Practice Address - Street 1:10407 STEVENSON RD
Practice Address - Street 2:
Practice Address - City:STEVENSON
Practice Address - State:MD
Practice Address - Zip Code:21153-0600
Practice Address - Country:US
Practice Address - Phone:410-764-8500
Practice Address - Fax:410-764-8504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12513261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental