Organization
CCDC PROFESSIONALS, LLC
Active
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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