Provider Demographics
NPI:1356158463
Name:CHILDREN'S DENTISTRY OF GERMANTOWN
Entity type:Organization
Organization Name:CHILDREN'S DENTISTRY OF GERMANTOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:IFEANYI
Authorized Official - Middle Name:ALEX
Authorized Official - Last Name:OKOYE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:281-857-5514
Mailing Address - Street 1:20500 SENECA MEADOWS PKWY STE 2300
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-7009
Mailing Address - Country:US
Mailing Address - Phone:301-820-7158
Mailing Address - Fax:
Practice Address - Street 1:20500 SENECA MEADOWS PKWY STE 2300
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7009
Practice Address - Country:US
Practice Address - Phone:301-820-7158
Practice Address - Fax:240-477-5814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty