Provider Demographics
NPI:1740335793
Name:TMJ MANAGEMENT SERVICES INC
Entity type:Organization
Organization Name:TMJ MANAGEMENT SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:K
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-897-3350
Mailing Address - Street 1:10215 FERNWOOD ROAD
Mailing Address - Street 2:#601
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817
Mailing Address - Country:US
Mailing Address - Phone:301-897-3350
Mailing Address - Fax:301-897-5571
Practice Address - Street 1:10215 FERNWOOD ROAD
Practice Address - Street 2:#601
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817
Practice Address - Country:US
Practice Address - Phone:301-897-3350
Practice Address - Fax:301-897-3350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD34811223D0001X
121151223D0001X
MD45901223P0300X
MD73171223P0700X
MD127051223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Not Answered1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDSA491684Medicare ID - Type Unspecified
U49092Medicare UPIN
U98853Medicare UPIN
T73415Medicare UPIN
U50665Medicare UPIN
MDMI765860Medicare ID - Type Unspecified
MDBI422113Medicare ID - Type Unspecified
MDSI175199Medicare ID - Type Unspecified