Provider Demographics
NPI:1376123406
Name:DYNAMIC DENTAL SERVICES LLC
Entity Type:Organization
Organization Name:DYNAMIC DENTAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KWEKU
Authorized Official - Middle Name:L
Authorized Official - Last Name:JANGHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-879-8337
Mailing Address - Street 1:13401 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1243
Mailing Address - Country:US
Mailing Address - Phone:301-879-8337
Mailing Address - Fax:
Practice Address - Street 1:13401 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1243
Practice Address - Country:US
Practice Address - Phone:301-879-8337
Practice Address - Fax:301-879-5430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty