Healthcare Provider Details

I. General information

NPI: 1164183562
Provider Name (Legal Business Name): BELL PEDIATRIC DENTISTRY & ORTHODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2022
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2012 HECHT AVE NE
WASHINGTON DC
20002-1668
US

IV. Provider business mailing address

715 INGRAHAM ST NW
WASHINGTON DC
20011-7707
US

V. Phone/Fax

Practice location:
  • Phone: 202-669-6571
  • Fax:
Mailing address:
  • Phone: 202-669-6571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JARRETT CALDWELL
Title or Position: PRINCIPAL
Credential: DDS
Phone: 202-669-6571