Provider Demographics
NPI:1790868867
Name:LAROSILIERE, CAROLINE REBECCA (DDS)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:REBECCA
Last Name:LAROSILIERE
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 LAUREL BOWIE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4000
Mailing Address - Country:US
Mailing Address - Phone:301-805-5437
Mailing Address - Fax:301-805-5439
Practice Address - Street 1:6000 LAUREL BOWIE RD STE 200
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4000
Practice Address - Country:US
Practice Address - Phone:301-805-5437
Practice Address - Fax:301-805-5439
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1000025122300000X
SC110431223P0221X
TN125961223P0221X
ALD.007400-C1223P0221X
VA04014192151223P0221X
OH30.0277541223P0221X
MD123781223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC055828800Medicaid
MD407170100Medicaid