DR. SUSANNE SCHOPPERT WALLENGREN D.D.S. NPI 1932265055

NPI Information

NPI: 1932265055
Provider Name: DR. SUSANNE SCHOPPERT WALLENGREN, D.D.S.
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
2324 WEST JOPPA RD
SUITE 430
LUTHERVILLE, MD
ZIP 21093
Phone: (410) 321-0200
Get Directions

DR. Susanne Schoppert Wallengren, D.D.S. is a pediatric dentistry dentist in Lutherville, MD. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Susanne Schoppert Wallengren, D.D.S. NPI is 1932265055. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2324 WEST JOPPA RD
SUITE 430
LUTHERVILLE, MD
ZIP 21093
Phone: (410) 321-0200
Fax: (410) 825-1159

The enumeration date for this NPI number is 1/1/2007 and was last updated on 7/25/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		3351	NEW HAMPSHIRE	No
2	122300000X	Dentist		12747	MARYLAND	No
3	1223P0221X	Dentist	Pediatric Dentistry	DS039549	PENNSYLVANIA	No
4	1223P0221X	Dentist	Pediatric Dentistry	3351	NEW HAMPSHIRE	No
5	1223P0221X	Dentist	Pediatric Dentistry	12747	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	30304152	MEDICAID	NEW HAMPSHIRE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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