Healthcare Provider Details

I. General information

NPI: 1306757752
Provider Name (Legal Business Name): ROCKSTAR ORTHODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7838 EASTERN AVE NW STE D
WASHINGTON DC
20012-1335
US

IV. Provider business mailing address

7838 EASTERN AVE NW STE D
WASHINGTON DC
20012-1335
US

V. Phone/Fax

Practice location:
  • Phone: 202-596-9094
  • Fax: 202-609-7822
Mailing address:
  • Phone: 202-596-9094
  • Fax: 202-609-7822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: STELLA CHUKWU
Title or Position: OWNER
Credential:
Phone: 202-596-9094