Provider Demographics
NPI:1346259959
Name:WEINHARDT, LEWIS WILLIAM JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:WILLIAM
Last Name:WEINHARDT
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:L
Other - Middle Name:WILLIAM
Other - Last Name:WEINHARDT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3655 B OLD COURT ROAD
Mailing Address - Street 2:STE 25
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3963
Mailing Address - Country:US
Mailing Address - Phone:410-486-7210
Mailing Address - Fax:410-795-9447
Practice Address - Street 1:3655 B OLD COURT ROAD
Practice Address - Street 2:STE 25
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3963
Practice Address - Country:US
Practice Address - Phone:410-486-7210
Practice Address - Fax:410-795-9447
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD48591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice