Provider Demographics
NPI:1487800918
Name:RESPONDEK, AMY MARLENE (DDS)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:MARLENE
Last Name:RESPONDEK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12722 TEABERRY RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-3365
Mailing Address - Country:US
Mailing Address - Phone:586-202-0334
Mailing Address - Fax:
Practice Address - Street 1:6798 OAK HALL LN STE A1
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5167
Practice Address - Country:US
Practice Address - Phone:410-290-7757
Practice Address - Fax:410-290-8812
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16739122300000X, 1223S0112X
MI2901019804122300000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist