Provider Demographics
NPI:1467057539
Name:MONTGOMERY COUNTY DHHS
Entity Type:Organization
Organization Name:MONTGOMERY COUNTY DHHS
Other - Org Name:DENNIS AVE COMMUNICABLE DISEASE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM SPECIALIST II
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-777-3482
Mailing Address - Street 1:2000 DENNIS AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4136
Mailing Address - Country:US
Mailing Address - Phone:240-777-1643
Mailing Address - Fax:240-777-4750
Practice Address - Street 1:2000 DENNIS AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4136
Practice Address - Country:US
Practice Address - Phone:240-777-1643
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTGOMERY COUNTY MARYLAND GOVERNMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-04
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty