Healthcare Provider Details

I. General information

NPI: 1649108549
Provider Name (Legal Business Name): BARAKH DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 OLD WASHINGTON RD STE 302
WALDORF MD
20602-3251
US

IV. Provider business mailing address

3450 OLD WASHINGTON RD STE 302
WALDORF MD
20602-3251
US

V. Phone/Fax

Practice location:
  • Phone: 443-421-2091
  • Fax:
Mailing address:
  • Phone: 443-421-2091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL BARAKH
Title or Position: OWNER
Credential: DDS
Phone: 443-421-2091