Provider Demographics
NPI:1851283931
Name:MIKA, PAUL SCOTT (DDS)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:SCOTT
Last Name:MIKA
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 1:13810 PARKLAND DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-2743
Mailing Address - Country:US
Mailing Address - Phone:209-352-3203
Mailing Address - Fax:
Practice Address - Street 1:WALTER REED MEDICAL CENTER
Practice Address - Street 2:BETHESDA
Practice Address - City:FPO
Practice Address - State:AA
Practice Address - Zip Code:20889
Practice Address - Country:US
Practice Address - Phone:301-400-2060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1117601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice