MEDICARE: DR. AMIR S BAREKATAIN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	122300000X	Dentist	0401416233	VA

General Provider Information

NPI Number	:	1679094866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMIR S BAREKATAIN DDS

Provider Business Mailing Address
First Line	:	300 N CHARLES ST STE D
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21201-4305
Country	:	US
Telephone Number	:	410-685-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 N CHARLES ST STE D
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21201-4305
Country	:	US
Telephone Number	:	410-685-0002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2017
Last Update Date	:	01/02/2022

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