Organization
CHILDREN'S HOSPITAL
Active
Other names
DEPARTMENT OF DENTISTRY
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLICIA NELSON (EXEC DIR-PAYOR FINANCIAL RELATIONS)
(301) 572-6281
Entity
Organization
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-6706
Mailing address
PO BOX 745842, ATLANTA, GA 30374-5842
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
HFD01-0208
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028002700
—
DC
05
—
760664800
—
MD
Enumeration date
11/05/2009
Last updated
09/02/2025
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