Provider Demographics
NPI:1053534743
Name:GINSBERG, EDWARD LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:LEE
Last Name:GINSBERG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 DIAMOND CREST CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1500
Mailing Address - Country:US
Mailing Address - Phone:410-653-3080
Mailing Address - Fax:
Practice Address - Street 1:1134 N ROLLING RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-3826
Practice Address - Country:US
Practice Address - Phone:410-788-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD78861223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7886OtherSTATE DENTAL LICENSE