Healthcare Provider Details

I. General information

NPI: 1497671572
Provider Name (Legal Business Name): KAILYN NICHOLE FIOCCA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13097 WISTERIA DR
GERMANTOWN MD
20874-2621
US

IV. Provider business mailing address

30 COUNTY CT
GAITHERSBURG MD
20878-2811
US

V. Phone/Fax

Practice location:
  • Phone: 301-540-2444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18766
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: