Healthcare Provider Details

I. General information

NPI: 1477767853
Provider Name (Legal Business Name): KEVIN G. MURPHY DDS,MS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 04/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6080 FALLS RD STE 202
BALTIMORE MD
21209-2498
US

IV. Provider business mailing address

6080 FALLS RD STE 202
BALTIMORE MD
21209-2498
US

V. Phone/Fax

Practice location:
  • Phone: 410-372-0202
  • Fax: 410-372-0311
Mailing address:
  • Phone: 410-372-0202
  • Fax: 410-372-0311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number14556
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5665
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number9124
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number9124
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number3450
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2465
License Number StateMD
# 7
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number5373
License Number StateMD
# 8
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number3670
License Number StateMD
# 9
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number7836
License Number StateMD
# 10
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number2918
License Number StateMD
# 11
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number4279
License Number StateMD
# 12
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number3352
License Number StateMD
# 13
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number13984
License Number StateMD

VIII. Authorized Official

Name: KEVIN GEORGE MURPHY
Title or Position: OWNER
Credential: DDS, MS
Phone: 410-372-0202