Healthcare Provider Details

I. General information

NPI: 1740335793
Provider Name (Legal Business Name): TMJ MANAGEMENT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10215 FERNWOOD ROAD #601
BETHESDA MD
20817
US

IV. Provider business mailing address

10215 FERNWOOD ROAD #601
BETHESDA MD
20817
US

V. Phone/Fax

Practice location:
  • Phone: 301-897-3350
  • Fax: 301-897-3350
Mailing address:
  • Phone: 301-897-3350
  • Fax: 301-897-5571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number3481
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number4590
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number7317
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number12705
License Number StateMD
# 5
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number12115
License Number State

VIII. Authorized Official

Name: MRS. FAITH K ANDERSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 301-897-3350