Organization
FIDEL DENTAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIANA BENINI (OFFICE MANAGER)
(202) 362-7413
Entity
Organization
Contact information
Practice address
4400 JENIFER ST NW, SUITE 335, WASHINGTON, DC 20015-2113
(202) 362-7413
Mailing address
4400 JENIFER ST NW, SUITE 335, WASHINGTON, DC 20015-2113
(202) 362-7413
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DEN1001296
DC
1223P0221X
Pediatric Dentistry
Primary
DEN5886
DC
1223P0300X
Periodontics
DEN5669
DC
1223P0700X
Prosthodontics
DEN1000570
DC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DEN1000355
DC
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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