DR. DAVID C BASTACKY (NPI# 1164429387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164429387 |
| Entity Type | Individual |
| Full Name | DR. DAVID C BASTACKY |
| Credential | DMD |
| Practice Address |
516 N Rolling Rd Suite 104 Baltimore MD 21228-4140 |
| Practice Telephone | 4107444222 |
| Practice Fax Number | 4107442472 |
| Mailing Telephone | 4107444222 |
| Mailing Fax Number | 4107442472 |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2019-04-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | 10337 | MD | Allopathic & Osteopathic Physicians |
| Street Address |
516 N ROLLING RD SUITE 104 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21228-4140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144223132 | Paul Sangtaek Yi | Dentist | 516 N Rolling Rd, Ste 102, Baltimore, MD 21228-4141 | 2005-05-23 |
| 1609480870 | Greenland Behavioral Health, LLC | Nurse Practitioner | 516 N Rolling Rd, Baltimore, MD 21228-4140 | 2020-09-03 |
| 1295170074 | Lifebridge Community Physicians, Inc | Internal Medicine | 516 N Rolling Rd, Baltimore, MD 21228-4140 | 2013-05-07 |
| 1245355312 | David C Bastacky Dmd Pa | Dentist | 516 N Rolling Rd, Suite 104, Baltimore, MD 21228-4140 | 2007-03-20 |
| 1538172903 | Michael Larry Davidson | Dentist | 516 N Rolling Rd, Suite 207, Baltimore, MD 21228-4140 | 2006-08-15 |
| 1932136413 | Katherine Rickle Payne | Physical Therapist | 516 N Rolling Rd, Suite 302, Baltimore, MD 21228-4140 | 2006-06-28 |
| 1356390108 | Mid-atlantic Nephrology Associates Pa | Internal Medicine | 516 N Rolling Rd, Suite 304, Baltimore, MD 21228-4140 | 2006-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699307975 | Playful Minds | Social Worker | 1009 Frederick Road, Baltimore, MD 21228 | 2020-02-05 |
| 1649818329 | Resolute Medical Care LLC | Nurse Practitioner | 4 E. Rolling Crossroads, Ste 100, Catonsville, MD 21228 | 2019-12-13 |
| 1760020416 | Bh Brightview Rolling Hills Opco, LLC | Alzheimer Center (Dementia Center) | 848 South Rolling Road, Catonsville, MD 21228 | 2019-12-12 |
| 1912542812 | Tiana Green | Counselor | 606 Edmondson Ave., Catonsville, MD 21228 | 2019-11-14 |
| 1699324806 | Maryland Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4701 Wilkens Ave, Catonsville, MD 21228 | 2019-09-10 |
| 1528613460 | Hyung Joon Kim Dds PC | Dentist | 516 N. Rolling Rd, #201, Catonsville, MD 21228 | 2019-08-07 |
| 1982109658 | William Jones | Counselor | 29 Tentmill Lane, Pikesville, MD 21228 | 2018-03-26 |
| 1740783752 | Jean Walter Infusion Center, LLC | Clinic/Center | 700 Geipe Road St. 100, Catonsville, MD 21228 | 2018-03-15 |
| 1174036578 | Ideal Telemedicine Services, LLC | Clinic/Center | 516 N Rolling Rd Ste 301, Catonsville, MD 21228 | 2017-11-08 |
| 1932627239 | Mind Over Matter Health Services, Inc. | Community/Behavioral Health | 616 Old Edmondson Ave. Ste. 4, Baltimore, MD 21228 | 2017-09-07 |
| Find all providers in zip 21228 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467446344 | John F Caccamese Jr. | Oral & Maxillofacial Surgery | 650 W. Baltimore St., Suite 1401, Baltimore, MD 21201 | 2005-09-07 |
| 1982016812 | Leah Irene Leinbach | Oral & Maxillofacial Surgery | The Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21287-0001 | 2014-05-27 |
| 1790944478 | Robin Yang | Oral & Maxillofacial Surgery | 666 W Baltimore St, Oral & Maxillofacial Surgery, 3-g23, Baltimore, MD 21201-1510 | 2008-06-06 |
| 1386637841 | Alexander E Pazoki | Oral & Maxillofacial Surgery | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2005-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679902407 | Antoine G Johnson Dds LLC | Oral & Maxillofacial Surgery | 3450 Ellicott Center Dr, 104, Ellicott City, MD 21043-4172 | 2013-11-02 |
| 1366889479 | Eric J Wu | Oral & Maxillofacial Surgery | 5900 Waterloo Rd Ste 220, Columbia, MD 21045-2638 | 2013-05-30 |
| 1043656655 | Scott Seung Young Kim | Oral & Maxillofacial Surgery | 6201 Greenbelt Rd Ste M1, College Park, MD 20740-2358 | 2013-05-22 |
| 1760558787 | Michael E Suden | Oral & Maxillofacial Surgery | 12166 Old Big Bend, Ste 101, Kirkwood, MD 63122 | 2006-11-28 |
| 1811060734 | Behrens & Kishter PC | Oral & Maxillofacial Surgery | 11404 Old Georgetown Road, Suite 104, Rockville, MD 20852 | 2006-11-16 |
| 1639141609 | Peter M Tan | Oral & Maxillofacial Surgery | 68 Thomas Johnson Dr, Suite A, Frederick, MD 21702 | 2006-02-03 |
| 1992798524 | Leonard Spector | Oral & Maxillofacial Surgery | 10 Warren Rd, Ste 330, Cockeysville, MD 21030-2506 | 2005-08-30 |
| 1023001641 | Spector & Krupps Dds | Oral & Maxillofacial Surgery | 1220b E Joppa Rd, Ste 314, Towson, MD 21286-5813 | 2005-08-30 |
| 1811998966 | Barry Ronald Berman | Oral & Maxillofacial Surgery | 110 Painters Mill Rd, Suite 8, Owings Mills, MD 21117-4920 | 2005-08-10 |
| 1083025662 | Neel Patel | Oral & Maxillofacial Surgery | 5530 Wisconsin Ave Ste 930, Chevy Chase, MD 20815-4316 | 2014-05-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.