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General NPI Number Information
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NPI Number | 1356158463
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Entity Type | Organization
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Legal Business Name | CHILDREN'S DENTISTRY OF GERMANTOWN
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 20300 SENECA MEADOWS PKWY STE 100
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City | GERMANTOWN
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State | MD
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Zip | 20876-7010
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Country | US
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Telephone | 301-820-7158
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Fax | 240-477-5814
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Provider Business Mailing Address
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Address Line | 20300 SENECA MEADOWS PKWY STE 100
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City | GERMANTOWN
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State | MD
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Zip | 20876-7010
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Country | US
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Telephone | 301-820-7158
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | IFEANYI ALEX OKOYE
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Credential |
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Telephone | 281-857-5514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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