Provider Demographics
NPI:1588928485
Name:FOSTER-JORDAN, MARIAN B (DDS)
Entity type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:B
Last Name:FOSTER-JORDAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MARIAN
Other - Middle Name:B
Other - Last Name:FOSTER-JORDAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:8630 FENTON ST STE 718
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3812
Mailing Address - Country:US
Mailing Address - Phone:301-388-8600
Mailing Address - Fax:
Practice Address - Street 1:8630 FENTON ST STE 718
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:301-388-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413598122300000X
MD15002122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist