Healthcare Provider Details

I. General information

NPI: 1720901457
Provider Name (Legal Business Name): DENTAL ASSOCIATES OF MARYLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4808 DEL RAY AVE STE 104
BETHESDA MD
20814-3014
US

IV. Provider business mailing address

2618 UNIVERSITY PL NW UNIT 4
WASHINGTON DC
20009-6372
US

V. Phone/Fax

Practice location:
  • Phone: 202-753-6542
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. NADER SIDHOM
Title or Position: OWNER DENTIST
Credential: DMD
Phone: 202-753-6542