Healthcare Provider Details

I. General information

NPI: 1487599866
Provider Name (Legal Business Name): WILDFLOWER ENDODONTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11510 OLD GEORGETOWN RD STE E
ROCKVILLE MD
20852-2786
US

IV. Provider business mailing address

10617 CAMILLIA BLOSSOM LN
AUSTIN TX
78748-3009
US

V. Phone/Fax

Practice location:
  • Phone: 301-493-4496
  • Fax:
Mailing address:
  • Phone: 281-795-8983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. KORTNIE STROTHER
Title or Position: PRESIDENT
Credential: DDS, MS, MSD
Phone: 281-795-8983