Provider Demographics
NPI:1184437261
Name:ELITE ROOT CANAL SPECIALTIES LAUREL
Entity type:Organization
Organization Name:ELITE ROOT CANAL SPECIALTIES LAUREL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:IJEOMA
Authorized Official - Last Name:OKEHIE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:301-776-1030
Mailing Address - Street 1:7525 GREENWAY CENTER DR STE T6
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3527
Mailing Address - Country:US
Mailing Address - Phone:240-219-9010
Mailing Address - Fax:
Practice Address - Street 1:14333 LAUREL BOWIE RD STE 300
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1183
Practice Address - Country:US
Practice Address - Phone:301-776-1030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty