NPI 1912363573 · live from the CMS NPI Registry
Fidel Dental Group, PLLC
Dentist, Pediatric Dentistry in Washington, DC. National Provider Identifier 1912363573, active.
NPI record
| NPI | 1912363573 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Pediatric Dentistry 1223P0221X |
| Practice location | 4400 Jenifer St Nw, Suite 335, Washington, DC 20015 |
| Practice phone | 202-362-7413 |
| Enumerated | January 12, 2016 |
| Last updated | January 12, 2016 |
| Authorized official | Juliana Benini, Office Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice | 1223G0001X | DEN1001296 (DC) |
| Dentist, Periodontics | 1223P0300X | DEN5669 (DC) |
| Dentist, Prosthodontics | 1223P0700X | DEN1000570 (DC) |
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | DEN1000355 (DC) |
| Dentist, Pediatric Dentistry primary | 1223P0221X | DEN5886 (DC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.