Semeona Marquez Acuzar-Brillantes, RDH
Individual provider Active NPI Dental Hygienist · Waldorf, MD
NPI 1720845019 · NPPES record last updated Mar 4, 2024
Key facts
- NPI
- 1720845019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 7539 (MD)
- Practice address
- 173 Saint Patricks Dr
Waldorf, MD 20603-5529 - Phone
- (301) 645-6500
- NPI assigned
- Mar 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7539 | MD | MD | Dental Hygienist |
| 219670 | MD | MD | Dental Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 219670 | MD | |
| Dental Hygienist | 124Q00000X | 7539 | MD | Yes |
Addresses
Primary practice location
173 Saint Patricks Dr
Waldorf, MD 20603-5529
Mailing address
9275 Biscayne St
Waldorf, MD 20603-7027
Phone (240) 838-4064
Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.