Provider Demographics
NPI:1740321256
Name:ANGELA S. WIREDU, DDS, PA
Entity type:Organization
Organization Name:ANGELA S. WIREDU, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WIREDU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-220-1790
Mailing Address - Street 1:7861 BELLE POINT DR
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3350
Mailing Address - Country:US
Mailing Address - Phone:301-220-1790
Mailing Address - Fax:301-220-1791
Practice Address - Street 1:7861 BELLE POINT DR
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3350
Practice Address - Country:US
Practice Address - Phone:301-220-1790
Practice Address - Fax:301-220-1791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD116091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty