Provider Demographics
NPI:1245995901
Name:CHOWDHURY, NAFISA FAIRUZ (DDS)
Entity type:Individual
Prefix:DR
First Name:NAFISA
Middle Name:FAIRUZ
Last Name:CHOWDHURY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 KENILWORTH TER NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-1898
Mailing Address - Country:US
Mailing Address - Phone:202-469-4699
Mailing Address - Fax:
Practice Address - Street 1:765 KENILWORTH TER NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1898
Practice Address - Country:US
Practice Address - Phone:202-839-7972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-07
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD176851223G0001X
DCDEN00000761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice