Healthcare Provider Details

I. General information

NPI: 1932338142
Provider Name (Legal Business Name): JEFFREY PEARLMAN D.D.S., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 11/15/2021
Certification Date: 11/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18638 CRESTWOOD DR
HAGERSTOWN MD
21742-2752
US

IV. Provider business mailing address

18638 CRESTWOOD DRIVE
HAGERSTOWN MD
21742
US

V. Phone/Fax

Practice location:
  • Phone: 301-797-6950
  • Fax: 301-797-4484
Mailing address:
  • Phone: 301-797-6950
  • Fax: 301-797-4484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8503
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number14048
License Number StateMD

VIII. Authorized Official

Name: ALLAN ISAAC SEIDMAN
Title or Position: OWNER
Credential: DDS
Phone: 301-797-6950