Provider Demographics
NPI:1730291188
Name:BALCIUNAS, BIRUTE ANTONIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:BIRUTE
Middle Name:ANTONIA
Last Name:BALCIUNAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:783 SONNE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7120
Mailing Address - Country:US
Mailing Address - Phone:410-266-5270
Mailing Address - Fax:410-659-0902
Practice Address - Street 1:600 LLIGHT ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-3856
Practice Address - Country:US
Practice Address - Phone:410-659-0900
Practice Address - Fax:410-659-0902
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0700881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
U19105Medicare UPIN
V239Medicare ID - Type Unspecified