Provider Demographics
NPI:1982203105
Name:EZ DENTAL CARE LLC
Entity Type:Organization
Organization Name:EZ DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEKSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TANEJA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:240-491-2244
Mailing Address - Street 1:10000 PRESTWICH TER
Mailing Address - Street 2:
Mailing Address - City:IJAMSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21754-9601
Mailing Address - Country:US
Mailing Address - Phone:240-491-2244
Mailing Address - Fax:
Practice Address - Street 1:775 HUNGERFORD DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1725
Practice Address - Country:US
Practice Address - Phone:301-545-1666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental