Healthcare Provider Details

I. General information

NPI: 1609250752
Provider Name (Legal Business Name): EDMOND REXHA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2015
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8955 WOOD RD
BETHESDA MD
20889-5628
US

IV. Provider business mailing address

8955 WOOD RD
BETHESDA MD
20889-5628
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-4675
  • Fax:
Mailing address:
  • Phone: 301-319-4675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDN31243
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number0401414958
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: