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General NPI Number Information
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NPI Number | 1952239667
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Entity Type | Organization
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Legal Business Name | CAPITAL KIDS DENTISTRY AND ORTHODONTICS
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Dates
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Enumeration Date | 05/12/2026
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 1300 SPRING ST STE 8788
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City | SILVER SPRING
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State | MD
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Zip | 20910-3616
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Country | US
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Telephone | 227-229-0170
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 SPRING ST STE 8788
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City | SILVER SPRING
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State | MD
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Zip | 20910-3616
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Country | US
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Telephone | 227-229-0170
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PAYER RELATIONS
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Name | CASSANDRA WIETH
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Credential |
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Telephone | 623-267-8121
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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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