Healthcare Provider Details

I. General information

NPI: 1831015692
Provider Name (Legal Business Name): NATIONAL CAPITAL CENTER FOR JAW SURGERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5454 WISCONSIN AVE STE 1040
CHEVY CHASE MD
20815-6915
US

IV. Provider business mailing address

5454 WISCONSIN AVE STE 1040
CHEVY CHASE MD
20815-6915
US

V. Phone/Fax

Practice location:
  • Phone: 240-728-2970
  • Fax: 240-728-2498
Mailing address:
  • Phone: 240-728-2970
  • Fax: 240-728-2498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: CAITLIN B.L. MAGRAW
Title or Position: ORAL AND MAXILLOFACIAL SURGEON
Credential: MD, DDS
Phone: 240-728-2970