Healthcare Provider Details

I. General information

NPI: 1396454849
Provider Name (Legal Business Name): WILMARY FLEISCHMANN RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 S LINWOOD AVE UNIT 200
BALTIMORE MD
21224-5091
US

IV. Provider business mailing address

2204 ESSEX ST
BALTIMORE MD
21231-3211
US

V. Phone/Fax

Practice location:
  • Phone: 410-921-0097
  • Fax:
Mailing address:
  • Phone: 682-465-7432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number13576
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number002026552
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberA9170
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: