=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821975616
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AYSENUR GENC DMD LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2025
-----------------------------------------------------
Last Update Date | 08/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 120 SISTER PIERRE DR STE 103
-----------------------------------------------------
City | TOWSON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21204-7521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-520-1440
-----------------------------------------------------
Fax | 410-450-3150
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 120 SISTER PIERRE DR STE 103
-----------------------------------------------------
City | TOWSON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21204-7521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-520-1440
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST
-----------------------------------------------------
Name | DR. AYSENUR GENC
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 410-520-1440
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223S0112X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------