Healthcare Provider Details

I. General information

NPI: 1215625371
Provider Name (Legal Business Name): SANA P. AUGUSTUS, DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10750 COLUMBIA PIKE STE 300
SILVER SPRING MD
20901-4453
US

IV. Provider business mailing address

10750 COLUMBIA PIKE STE 300
SILVER SPRING MD
20901-4453
US

V. Phone/Fax

Practice location:
  • Phone: 301-708-3012
  • Fax:
Mailing address:
  • Phone: 301-708-3012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. SANA P AUGUSTUS
Title or Position: OWNER/ORTHODONTIST
Credential: DDS
Phone: 301-708-3012