Healthcare Provider Details

I. General information

NPI: 1982744884
Provider Name (Legal Business Name): FELDMAN, SACHS & FITZGERALD, DDS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 KENILWORTH DR SUITE 103
TOWSON MD
21204-2313
US

IV. Provider business mailing address

660 KENILWORTH DR SUITE 103
TOWSON MD
21204-2313
US

V. Phone/Fax

Practice location:
  • Phone: 410-821-8800
  • Fax: 410-823-5715
Mailing address:
  • Phone: 410-821-8800
  • Fax: 410-823-5715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number6720
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number4013
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number10821
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number6720
License Number StateMD
# 5
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number4013
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ROBERT I SACHS
Title or Position: VICE PRESIDENT
Credential: DDS
Phone: 410-821-8800