Healthcare Provider Details

I. General information

NPI: 1265295661
Provider Name (Legal Business Name): AYSENUR GENC DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AYSENUR UZUN DMD

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 05/24/2025
Certification Date: 05/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 SISTER PIERRE DR STE 103
TOWSON MD
21204-7521
US

IV. Provider business mailing address

120 SISTER PIERRE DR STE 103
TOWSON MD
21204-7521
US

V. Phone/Fax

Practice location:
  • Phone: 608-320-3820
  • Fax:
Mailing address:
  • Phone: 608-320-3820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS044918
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN10000448
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number18597
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS044918
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: