Provider Demographics
NPI:1366798688
Name:EMIKE USMAN-ALIU DDS LLC
Entity type:Organization
Organization Name:EMIKE USMAN-ALIU DDS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:EMIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:USMAN-ALIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-262-8500
Mailing Address - Street 1:14300 GALLANT FOX LN STE 112
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14300 GALLANT FOX LN STE 112
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4031
Practice Address - Country:US
Practice Address - Phone:240-232-2956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14914261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental