Provider Demographics
NPI:1831548908
Name:DOOLEY, KEVIN PATRICK (DDS)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:PATRICK
Last Name:DOOLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 SANDY SPRING RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1307
Mailing Address - Country:US
Mailing Address - Phone:301-622-1717
Mailing Address - Fax:
Practice Address - Street 1:4009 SANDY SPRING RD STE 201
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1307
Practice Address - Country:US
Practice Address - Phone:301-622-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16120122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist