Individual provider Active NPI

Tania Chimwemwe Nkungula, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Largo, MD
National Provider Identifier
1689663346
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
14426 Issued in MD
Practice address
1401 Mercantile LN
Suite 102
Largo, MD 20774-4301
Phone
(301) 341-0041
Fax
(301) 341-0014
NPI assigned
Oct 17, 2005
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DEN1000908 DC
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 14426 MD Primary

Addresses

Primary practice location

1401 Mercantile LN
Suite 102
Largo, MD 20774-4301

Mailing address

1401 Mercantile LN
Suite 102
Largo, MD 20774-4301
Phone (301) 341-0041

Other names 1

  • Tania Nkungula-Howlett Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201109002535 MD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2466402649

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14426MDMDClinical Social Worker
DEN1000908DCMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Specialty Group Past Accepting new patients
Washington Oral Surgery Center, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1689663346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN",
            "address_2": "SUITE 102",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744301",
            "telephone_number": "301-341-0041",
            "fax_number": "301-341-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN",
            "address_2": "SUITE 102",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744301",
            "telephone_number": "301-341-0041",
            "fax_number": "301-341-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKUNGULA",
        "first_name": "TANIA",
        "middle_name": "CHIMWEMWE",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DC",
            "license": "DEN1000908",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "14426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANIA",
            "last_name": "NKUNGULA-HOWLETT",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Largo, MD

Sources for this page

Verify at the official NPI Registry.