Healthcare Provider Details

I. General information

NPI: 1164941605
Provider Name (Legal Business Name): MOHAMEAD BAKIR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2017
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15805 CRABBS BRANCH WAY UNIT A
DERWOOD MD
20855-2635
US

IV. Provider business mailing address

15805 CRABBS BRANCH WAY UNIT A
DERWOOD MD
20855-2635
US

V. Phone/Fax

Practice location:
  • Phone: 301-740-4750
  • Fax:
Mailing address:
  • Phone: 301-740-4750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number16555
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: