Healthcare Provider Details

I. General information

NPI: 1366378804
Provider Name (Legal Business Name): JOSEPHENE CARR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22109 JEFFERSON BLVD
SMITHSBURG MD
21783-2059
US

IV. Provider business mailing address

1776 SPRINGFIELD LN
FREDERICK MD
21702-3067
US

V. Phone/Fax

Practice location:
  • Phone: 301-824-5111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18808
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: