Provider Demographics
NPI:1013522184
Name:NIU DENTISTRY TOWSON LLC
Entity Type:Organization
Organization Name:NIU DENTISTRY TOWSON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:NIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PHD
Authorized Official - Phone:410-823-1751
Mailing Address - Street 1:7801 YORK RD STE 307
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7449
Mailing Address - Country:US
Mailing Address - Phone:410-823-1751
Mailing Address - Fax:
Practice Address - Street 1:7801 YORK RD STE 307
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7449
Practice Address - Country:US
Practice Address - Phone:410-823-1751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental