Healthcare Provider Details

I. General information

NPI: 1215439500
Provider Name (Legal Business Name): TERRI J MATTHEWS DMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 KENNEDY ST NW
WASHINGTON DC
20011-5227
US

IV. Provider business mailing address

8106 FOREVER GREEN CT
ELKRIDGE MD
21075-6477
US

V. Phone/Fax

Practice location:
  • Phone: 443-326-3606
  • Fax:
Mailing address:
  • Phone: 443-326-3606
  • Fax: 443-296-7137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License NumberDEN4045
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. TERRI J MATTHEWS
Title or Position: OWNER
Credential: DMD
Phone: 443-326-3606