Individual
MARIA JIVIDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4900 MASSACHUSETTS AVE NW STE 260, WASHINGTON, DC 20016-4358
(703) 537-6242
Mailing address
3418 PUTNAM ST, FALLS CHURCH, VA 22042-3727
(703) 537-6242
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0401418334
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DEN2000278
DC
Other
Enumeration date
06/07/2021
Last updated
10/27/2025
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