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General NPI Number Information
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NPI Number | 1982484424
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Entity Type | Organization
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Legal Business Name | PSM DENTAL PLLC
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 4914 CENTRAL AVE NE
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City | WASHINGTON
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State | DC
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Zip | 20019-5362
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Country | US
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Telephone | 240-751-0444
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 16TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-2502
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KARISHMA PATEL
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Credential | DDS
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Telephone | 240-751-0444
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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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