Healthcare Provider Details

I. General information

NPI: 1104053545
Provider Name (Legal Business Name): CHILO OBIANWU DMD. ALL SMILES DENTAL CARE P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12803 OLD FORT RD STE 203
FORT WASHINGTON MD
20744-2801
US

IV. Provider business mailing address

12803 OLD FORT RD STE 203
FORT WASHINGTON MD
20744-2801
US

V. Phone/Fax

Practice location:
  • Phone: 240-253-1965
  • Fax: 240-253-1966
Mailing address:
  • Phone: 240-253-1965
  • Fax: 240-253-1966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number13826
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHILO N OBIANWU
Title or Position: DMD
Credential:
Phone: 301-702-4080