Healthcare Provider Details

I. General information

NPI: 1609498724
Provider Name (Legal Business Name): HEALTHY SMILES DENTALCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11016 NEW HAMPSHIRE AVE
SILVER SPRING MD
20904-2602
US

IV. Provider business mailing address

304 MISTY KNOLL DR
ROCKVILLE MD
20850-2878
US

V. Phone/Fax

Practice location:
  • Phone: 703-623-2388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: QING XU
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 703-623-2388