Healthcare Provider Details

I. General information

NPI: 1801945290
Provider Name (Legal Business Name): DR. MARTIN L. OKUN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 WISCONSIN AVE SUITE 370
BETHESDA MD
20814-4810
US

IV. Provider business mailing address

7201 WISCONSIN AVE SUITE 370
BETHESDA MD
20814-4810
US

V. Phone/Fax

Practice location:
  • Phone: 301-656-1600
  • Fax: 301-656-0140
Mailing address:
  • Phone:
  • Fax: 301-656-0140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number5747
License Number StateMD

VIII. Authorized Official

Name: MARTIN L. OKUN
Title or Position: ORTHODONTIST
Credential:
Phone: 301-656-1600