Healthcare Provider Details

I. General information

NPI: 1710266465
Provider Name (Legal Business Name): CAITLIN DORA DARCEY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. CAITLIN DARCEY LESTER

II. Dates (important events)

Enumeration Date: 08/12/2011
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 RITCHIE HWY STE 103
SEVERNA PARK MD
21146-4190
US

IV. Provider business mailing address

1306 BRISTOL RIDGE PL
CROWNSVILLE MD
21032-2217
US

V. Phone/Fax

Practice location:
  • Phone: 411-647-0200
  • Fax:
Mailing address:
  • Phone: 267-408-0975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number15035
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number15035
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: