Healthcare Provider Details

I. General information

NPI: 1013032903
Provider Name (Legal Business Name): CHERYL F CALLAHAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 03/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15225 SHADY GROVE ROAD STE 301 CHERYL F CALLAHAN DDS PA
ROCKVILLE MD
20850
US

IV. Provider business mailing address

15225 SHADY GROVE ROAD STE 301
ROCKVILLE MD
20850
US

V. Phone/Fax

Practice location:
  • Phone: 301-948-1212
  • Fax: 301-840-1722
Mailing address:
  • Phone: 301-948-1212
  • Fax: 301-840-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number9753
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number09753
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: