MEDICARE: CHARMING SMILES FAMILY DENTISTRY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	14418	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104319029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARMING SMILES FAMILY DENTISTRY, INC

Provider Business Mailing Address
First Line	:	14333 LAUREL BOWIE RD STE 301
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-1183
Country	:	US
Telephone Number	:	301-317-9020
Fax Number	:

Provider Business Practice Location Address
First Line	:	14333 LAUREL BOWIE RD STE 301
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-1183
Country	:	US
Telephone Number	:	301-317-9020
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NATALIE G. KELLEY
Credential	:	DDS
Telephone Number	:	301-317-9020

Provider Enumeration Date	:	06/14/2018
Last Update Date	:	02/18/2026

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