Provider Demographics
NPI:1235862236
Name:MEGGISON, TEMISAN (DDS)
Entity type:Individual
Prefix:DR
First Name:TEMISAN
Middle Name:
Last Name:MEGGISON
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 1:3460 14TH ST NW APT 420
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-4409
Mailing Address - Country:US
Mailing Address - Phone:857-247-7684
Mailing Address - Fax:
Practice Address - Street 1:7201 WISCONSIN AVE STE 310
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4846
Practice Address - Country:US
Practice Address - Phone:301-564-4991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17963122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program