1063655256 NPI number — ASPEN HILL IMPLANT & FAMILY DENTISTRY, P. C.

Table of content: (NPI 1063655256)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063655256 NPI number — ASPEN HILL IMPLANT & FAMILY DENTISTRY, P. C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASPEN HILL IMPLANT & FAMILY DENTISTRY, P. C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1063655256
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4110 ASPEN HILL RD STE 301
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20853-2853
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-871-5830
Provider Business Mailing Address Fax Number:
301-871-7519

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 MERCANTILE LN STE 583
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LARGO
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20774-4321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-773-4177
Provider Business Practice Location Address Fax Number:
301-773-9626
Provider Enumeration Date:
04/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
AHMED
Authorized Official First Name:
ZIA
Authorized Official Middle Name:
Authorized Official Title or Position:
DENTIS
Authorized Official Telephone Number:
301-871-5830

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  11398 , 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)





Copyright © 2007-2025 www.npivalidator.com