Healthcare Provider Details

I. General information

NPI: 1811751316
Provider Name (Legal Business Name): JIAO FENG CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 HUNGERFORD DR STE 40A
ROCKVILLE MD
20850-1753
US

IV. Provider business mailing address

9708 DILSTON RD
SILVER SPRING MD
20903-1915
US

V. Phone/Fax

Practice location:
  • Phone: 301-838-5955
  • Fax: 301-838-5956
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JIAO FENG
Title or Position: DIRECTOR
Credential: CRNP
Phone: 301-655-8218