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General NPI Number Information
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NPI Number | 1609438597
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Entity Type | Individual
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Provider Name | MARIA MANGINE DDS
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Gender | Female
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 1426 21ST ST NW FL 2
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City | WASHINGTON
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State | DC
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Zip | 20036-5947
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Country | US
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Telephone | 202-331-3476
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Fax |
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Provider Business Mailing Address
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Address Line | 1804 BAY ST SE
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City | WASHINGTON
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State | DC
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Zip | 20003-2509
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Country | US
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Telephone | 315-558-2828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401416431
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16803
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN1001978
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License Number State | DC
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