Provider Demographics
NPI:1902698061
Name:NAZARETH FAMILY DENTAL
Entity type:Organization
Organization Name:NAZARETH FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EDEN
Authorized Official - Middle Name:WOLDESENTBET
Authorized Official - Last Name:AYANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:240-415-8222
Mailing Address - Street 1:1703 WILLOW SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-5601
Mailing Address - Country:US
Mailing Address - Phone:410-446-1404
Mailing Address - Fax:
Practice Address - Street 1:8501 COLESVILLE RD STE SUIT200
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3322
Practice Address - Country:US
Practice Address - Phone:240-415-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental