DR. PHILLIP BARRY SUROSKY (NPI# 1851422893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851422893 |
| Entity Type | Individual |
| Full Name | DR. PHILLIP BARRY SUROSKY |
| Credential | D.D.S. |
| Practice Address |
4821 Butler Road 2b Glyndon MD 21071 |
| Practice Telephone | 4108336200 |
| Practice Fax Number | 4108336365 |
| Mailing Telephone | 4108336200 |
| Mailing Fax Number | 4108336365 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2012-10-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 7474 | MD | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | TAX ID | 521400959 | 01 |
| Street Address |
4821 BUTLER ROAD 2B |
| City | GLYNDON |
| State | MD |
| Zip Code | 21071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194964015 | Northwest Dental Inc | Clinic/Center | 4821 Butler Road, Suite 2b, Glyndon, MD 21071 | 2009-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932212495 | Jay Christian Toth | Dentist | 4817 Butler Rd, Glyndon, MD 21071 | 2006-08-17 |
| 1316462146 | Leah Kaitlyn Romay | Dentist | 4817 Butler Rd, Glyndon, MD 21071-2100 | 2017-08-14 |
| 1295299568 | Therese Lynch | Speech-Language Pathologist | 325 Central Ave, Glyndon, MD 21071-4216 | 2019-01-30 |
| 1043602949 | Amonda Bentley Wroe | Nurse Practitioner | 317 Central Ave, Glyndon, MD 21071-4216 | 2015-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053934950 | Mtc Anesthesia Associates | Nurse Anesthetist, Certified Registered | 304 Hedgepocket Way, Glyndon, MD 21136-1816 | 2020-05-26 |
| 1689083735 | Jennifer L. Chavis | Nurse Practitioner | 4821 Butler Rd # 3c, Glyndon, MD 21136-5686 | 2014-08-02 |
| 1821420647 | Tami Lynn Sauer | Specialist | 420 Partridge Ave S, Glyndon, MN 56547-4311 | 2013-08-02 |
| 1609884956 | Christa M. Gredlein | Podiatrist | 4821 Butler Rd Ste 2d, Glyndon, MD 21136-5688 | 2006-08-03 |
| 1376054452 | Clinical Associates P A | Podiatrist | 4821 Butler Rd Ste 2d, Glyndon, MD 21136-5688 | 2017-10-17 |
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932212495 | Jay Christian Toth | Dentist | 4817 Butler Rd, Glyndon, MD 21071 | 2006-08-17 |
| 1316462146 | Leah Kaitlyn Romay | Dentist | 4817 Butler Rd, Glyndon, MD 21071-2100 | 2017-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918862 | Munder Omran Ben-omran | Dentist | 18535 Boysenberry Dr Apt 319, Gaithersburg, MD 20879-3690 | 2020-10-05 |
| 1982210423 | Kevin Wang | Dentist | 1057 W Perimeter Rd, Prince County, MD 20762 | 2020-09-21 |
| 1720692262 | Amanda Amaro | Dentist | 9408 Bruce Dr, Silver Spring, MD 20901-4812 | 2020-09-02 |
| 1790396927 | Kyle Westbrook | Dentist | 614 Eastern Shore Dr Ste D, Salisbury, MD 21804-5940 | 2020-08-12 |
| 1235749417 | Hanin Al-rubai | Dentist | 9936 Shelburne Ter Apt 101, Gaithersburg, MD 20878-5351 | 2020-08-03 |
| 1750999736 | Kyung Min Shin | Dentist | 11 S Eutaw St Apt 1609, Baltimore, MD 21201-1638 | 2020-07-16 |
| 1679181846 | Eric J Guida | Dentist | 832 Locust Dr, West River, MD 20778-9745 | 2020-07-14 |
| 1649897935 | Cory Kyser | Dentist | 1900 E Northern Pkwy Ste 103, Baltimore, MD 21239-2109 | 2020-07-02 |
| 1538786181 | Amstrong Njinguet | Dentist | 823 Booker Dr, Capitol Heights, MD 20743-1833 | 2020-06-30 |
| 1063038339 | Patrick Campbell | Dentist | 8300 Wisconsin Ave Apt 511, Bethesda, MD 20814-3194 | 2020-06-22 |
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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.