Provider Demographics
NPI:1497228936
Name:JAMES D PERKINS DDS LLC
Entity Type:Organization
Organization Name:JAMES D PERKINS DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-522-8852
Mailing Address - Street 1:4000 ANNAPOLIS RD REAR 101
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-3611
Mailing Address - Country:US
Mailing Address - Phone:410-789-0551
Mailing Address - Fax:410-789-0551
Practice Address - Street 1:4000 ANNAPOLIS RD REAR 101
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-3611
Practice Address - Country:US
Practice Address - Phone:410-789-0551
Practice Address - Fax:410-789-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1073938031Medicaid
MD1073938031OtherALL INSURANCE AND MEDICARE