Provider Demographics
NPI:1194427617
Name:HOMEY DENTAL GROUP LLC
Entity type:Organization
Organization Name:HOMEY DENTAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HARITH
Authorized Official - Middle Name:WAE
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-977-8855
Mailing Address - Street 1:6835 OLNEY LAYTONSVILLE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:LAYTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20882-1915
Mailing Address - Country:US
Mailing Address - Phone:013-977-8855
Mailing Address - Fax:301-977-8856
Practice Address - Street 1:6835 OLNEY LAYTONSVILLE RD STE 202
Practice Address - Street 2:
Practice Address - City:LAYTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20882-1915
Practice Address - Country:US
Practice Address - Phone:013-977-8855
Practice Address - Fax:301-977-8856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty