Organization
CCDC PROFESSIONALS, LLC
Active
Other names
Capital Children's General Anesthesia Dentistry LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY WHEELER (BUSINESS MANAGER)
(301) 494-3000
Entity
Organization
Contact information
Practice address
1220 CARAWAY CT STE 1050, UPPER MARLBORO, MD 20774-5338
(301) 494-3000
Mailing address
1220 CARAWAY CT STE 1050, UPPER MARLBORO, MD 20774-5338
(301) 494-3000
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
—
—
207L00000X
Anesthesiology Physician
Primary
—
—
207LP3000X
Pediatric Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
01/24/2023
Last updated
01/13/2026
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