Provider Demographics
NPI:1992827711
Name:WEINTRAUB, JOSHUA PAUL (DDS)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:PAUL
Last Name:WEINTRAUB
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 1:7211 PARK HEIGHTS AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208
Mailing Address - Country:US
Mailing Address - Phone:410-764-8500
Mailing Address - Fax:410-764-8504
Practice Address - Street 1:7211 PARK HEIGHTS AVE
Practice Address - Street 2:S 4
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208
Practice Address - Country:US
Practice Address - Phone:410-764-8500
Practice Address - Fax:410-764-8504
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12513122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist