Provider Demographics
NPI:1821128448
Name:MENDELSON, HERBERT MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:MARTIN
Last Name:MENDELSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11300 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1812
Mailing Address - Country:US
Mailing Address - Phone:410-356-4100
Mailing Address - Fax:
Practice Address - Street 1:11300 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-1812
Practice Address - Country:US
Practice Address - Phone:410-356-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD116161223G0001X
NY048822-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice