NPI Code Details Logo

NPI 1134076763

NPI 1134076763 : DOMINION FAMILY PRACTICE, LLC : LANHAM, MD

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1134076763
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    DOMINION FAMILY PRACTICE, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/12/2026
-----------------------------------------------------
    Last Update Date     |    03/12/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    8855 ANNAPOLIS RD STE 305 
-----------------------------------------------------
    City                 |    LANHAM
-----------------------------------------------------
    State                |    MD
-----------------------------------------------------
    Zip                  |    20706-2984
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    202-409-6564
-----------------------------------------------------
    Fax                  |    240-260-0790
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    8855 ANNAPOLIS RD STE 305 
-----------------------------------------------------
    City                 |    LANHAM
-----------------------------------------------------
    State                |    MD
-----------------------------------------------------
    Zip                  |    20706-2984
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    202-409-6564
-----------------------------------------------------
    Fax                  |    240-260-0790
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     BLESSING J MATTHEWS 
-----------------------------------------------------
    Credential           |    FNP
-----------------------------------------------------
    Telephone            |    202-409-6564
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207Q00000X
-----------------------------------------------------
    Taxonomy Name        |    Family Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.