Healthcare Provider Details

I. General information

NPI: 1013783430
Provider Name (Legal Business Name): MARY'S CENTER FOR MATERNAL & CHILD CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 ONTARIO RD NW
WASHINGTON DC
20009-2627
US

IV. Provider business mailing address

2333 ONTARIO RD NW
WASHINGTON DC
20009-2627
US

V. Phone/Fax

Practice location:
  • Phone: 202-483-8196
  • Fax: 202-478-1840
Mailing address:
  • Phone: 202-483-8196
  • Fax: 202-478-1840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MONIQUE MARGARETA POWELL-DAVIS
Title or Position: CHIEF MEDICAL OFFICER
Credential:
Phone: 202-424-2655