Healthcare Provider Details

I. General information

NPI: 1407740442
Provider Name (Legal Business Name): DR. PAUL EDWARD LINDEMUTH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S CLINTON ST STE 335
BALTIMORE MD
21224-5753
US

IV. Provider business mailing address

2809 BOSTON ST APT 427
BALTIMORE MD
21224-4853
US

V. Phone/Fax

Practice location:
  • Phone: 410-237-0174
  • Fax:
Mailing address:
  • Phone: 907-317-5425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number18891
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: