Provider Demographics
NPI:1710266465
Name:DARCEY, CAITLIN DORA (DMD)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:DORA
Last Name:DARCEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:CAITLIN
Other - Middle Name:DARCEY
Other - Last Name:LESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1306 BRISTOL RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:CROWNSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21032-2217
Mailing Address - Country:US
Mailing Address - Phone:267-408-0975
Mailing Address - Fax:
Practice Address - Street 1:900 RITCHIE HWY STE 103
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4190
Practice Address - Country:US
Practice Address - Phone:411-647-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD150351223P0300X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0300XDental ProvidersDentistPeriodontics