1346314481 NPI number — CHARMAINE A FOLKES DDS, PC

Table of content: (NPI 1346314481)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346314481 NPI number — CHARMAINE A FOLKES DDS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHARMAINE A FOLKES DDS, PC
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:
6
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:
1346314481
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10903 INDIAN HEAD HWY
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
FORT WASHINGTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20744-4011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-203-3944
Provider Business Mailing Address Fax Number:
301-203-3945

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10903 INDIAN HEAD HWY
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
FORT WASHINGTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20744-4011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-203-3944
Provider Business Practice Location Address Fax Number:
301-203-3945
Provider Enumeration Date:
11/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WYNTER
Authorized Official First Name:
CHARMAINE
Authorized Official Middle Name:
ANNE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
301-203-3944

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 872965 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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