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General NPI Number Information
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NPI Number | 1023454667
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Entity Type | Individual
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Provider Name | DMITRY NURMINSKY D.D.S., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/21/2013
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Last Update Date | 03/15/2016
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Provider Practice Location Address
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Address Line | 1522 POINTER RIDGE PL SUITE K
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City | BOWIE
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State | MD
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Zip | 20716-1875
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Country | US
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Telephone | 301-249-9098
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Fax |
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Provider Business Mailing Address
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Address Line | 1612 CHARMUTH RD ZDENTIST LLC
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City | LUTHERVILLE
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State | MD
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Zip | 21093-5757
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Country | US
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Telephone | 508-904-5287
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS039570
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 15795
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License Number State | MD
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