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PRESIDENTIAL PEDIATRIC DENTISTRY & ORTHODONTICS NPI 1114453610


NPI Information

NPI: 1114453610
Provider Name: PRESIDENTIAL PEDIATRIC DENTISTRY & ORTHODONTICS
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
350 EASTERN AVE NE
WASHINGTON, DC
ZIP 20019
Phone: (202) 248-6288
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PRESIDENTIAL PEDIATRIC DENTISTRY & ORTHODONTICS is a pediatric dentistry dentist in Washington, DC. 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. PRESIDENTIAL PEDIATRIC DENTISTRY & ORTHODONTICS NPI is 1114453610. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

350 EASTERN AVE NE
WASHINGTON, DC
ZIP 20019-833
Phone: (202) 248-6288
Fax: (202) 248-6330

The provider's authorized official is Kidanemariam Rozario .
The authorized official title is Practice Manager and has the following contact phone number (202) 248-6288.

The enumeration date for this NPI number is 5/4/2017 and was last updated on 5/4/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0221XDentistPediatric DentistryDEN1001643DISTRICT OF COLUMBIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1058025400MEDICAIDDISTRICT OF COLUMBIA

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: 4/28/2024

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