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General NPI Number Information
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NPI Number | 1003636036
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Entity Type | Organization
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Legal Business Name | CHEVY CHASE PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 8401 CONNECTICUT AVE STE 650
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City | CHEVY CHASE
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State | MD
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Zip | 20815-5839
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Country | US
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Telephone | 301-272-1246
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Fax | 301-272-1248
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Provider Business Mailing Address
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Address Line | 8401 CONNECTICUT AVE STE 650
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City | CHEVY CHASE
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State | MD
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Zip | 20815-5839
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Country | US
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Telephone | 301-272-1246
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Fax | 301-272-1248
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Authorized Official
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Title or Position | LLC, OWNER
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Name | DR. KAREN BENITEZ
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Credential | DDS
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Telephone | 301-272-1246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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