Provider Demographics
NPI:1477767853
Name:KEVIN G. MURPHY DDS,MS
Entity Type:Organization
Organization Name:KEVIN G. MURPHY DDS,MS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:410-372-0202
Mailing Address - Street 1:6080 FALLS RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2498
Mailing Address - Country:US
Mailing Address - Phone:410-372-0202
Mailing Address - Fax:410-372-0311
Practice Address - Street 1:6080 FALLS RD STE 202
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2498
Practice Address - Country:US
Practice Address - Phone:410-372-0202
Practice Address - Fax:410-372-0311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14556122300000X
MD56651223G0001X
MD91241223P0300X, 1223P0700X
MD3450124Q00000X
MD2465124Q00000X
MD5373124Q00000X
MD3670124Q00000X
MD7836126800000X
MD2918126800000X
MD4279126800000X
MD3352126800000X
MD13984126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty