Provider Demographics
NPI:1679787220
Name:TIU SILVA, MONICA F (DDS)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:F
Last Name:TIU SILVA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MONICA
Other - Middle Name:F
Other - Last Name:TIU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5701 FOGGY LN
Mailing Address - Street 2:
Mailing Address - City:DERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20855-1620
Mailing Address - Country:US
Mailing Address - Phone:347-460-3090
Mailing Address - Fax:
Practice Address - Street 1:1220 CARAWAY CT STE 1050
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5338
Practice Address - Country:US
Practice Address - Phone:301-494-3000
Practice Address - Fax:301-494-3333
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0534151223G0001X
MD158601223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03079921Medicaid