MEDICARE: DR. THEODORE MICHAEL DOUGHERTY D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	07093	MD

General Provider Information

NPI Number	:	1760767958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THEODORE MICHAEL DOUGHERTY D.D.S.

Provider Business Mailing Address
First Line	:	1812 GEORGIA AVE.
Second Line	:	SUITE 110
City	:	OLNEY
State	:	MD
Zip	:	20832-1437
Country	:	US
Telephone Number	:	240-390-0276
Fax Number	:

Provider Business Practice Location Address
First Line	:	18121 GEORGIA AVE
Second Line	:	SUITE 110
City	:	OLNEY
State	:	MD
Zip	:	20832-1437
Country	:	US
Telephone Number	:	240-390-0276
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2011
Last Update Date	:	10/19/2011

Similar Medicare Providers

1821850587 — PRIVIA MEDICAL GROUP, LLC
Practice Location Address:

18121 GEORGIA AVE STE 103
OLNEY, MD
20832-1437

Practice Phone: 301-933-5050
Practice Fax:

1831160233 — DAPHNA HENKIN MD
Practice Location Address:

18121 GEORGIA AVE STE 103
OLNEY, MD
20832-1437

Practice Phone: 301-933-5050
Practice Fax: 301-949-3262

1952340648 — SHASHANK G PATEL MD
Practice Location Address:

18121 GEORGIA AVE STE 103
OLNEY, MD
20832-1437

Practice Phone: 301-933-5050
Practice Fax: 301-949-3262

1376863837 — MS. KATHERINE MARY KEMPER-DEAN CRNP
Practice Location Address:

18121 GEORGIA AVE , SUITE 103
OLNEY, MD
20832-1437

Practice Phone: 301-933-5050
Practice Fax: 301-949-3262

1477819365 — DR. MONICA PAREKH CHANDRAN DMD, MS
Practice Location Address:

18121 GEORGIA AVE , SUITE 110
OLNEY, MD
20832-1437

Practice Phone: 240-454-5718
Practice Fax:

1528475274 — VIKASKUMAR PATEL
Practice Location Address:

18121 GEORGIA AVE STE 110
OLNEY, MD
20832-1437

Practice Phone: 240-390-0290
Practice Fax:

Directions to “ DR. THEODORE MICHAEL DOUGHERTY D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.