1417019001 NPI number — DR. TODD ROBERT SARUBIN DDS

Table of content: DR. TODD ROBERT SARUBIN DDS (NPI 1417019001)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417019001 NPI number — DR. TODD ROBERT SARUBIN DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SARUBIN
Provider First Name:
TODD
Provider Middle Name:
ROBERT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417019001
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
08/20/2008
NPI Reactivation Date:
06/02/2011

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 REGISTERSTOWN ROAD
Provider Second Line Business Mailing Address:
STE 124
Provider Business Mailing Address City Name:
PIKESVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-594-9500
Provider Business Mailing Address Fax Number:
410-594-9216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 REGISTERSTOWN ROAD
Provider Second Line Business Practice Location Address:
STE 124
Provider Business Practice Location Address City Name:
PIKESVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-594-9500
Provider Business Practice Location Address Fax Number:
410-594-9216
Provider Enumeration Date:
12/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  8966 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 48487 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com