Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shady Grove Dermatology

Organization Specialist · NPI 1790177210

Shady Grove Dermatology is a Specialist in Rockville, Maryland. Licensed in Maryland. Registered with an NPI since 2015.

Licensed in
MD
In the registry since
2015
Specialties on file
2

Practice location Address checks out

15245 Shady Grove Rd Ste 370
Rockville, MD 20850-3222
Phone: (240) 246-7417
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence D0028453 (MD)
Medical Specialty Clinic/Center Taxonomy 261QM2500X

Record details

NPI number1790177210
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sandee Davidson — Business Consultant · (240) 246-7417
Other names Shady Grove Dermatology, Llc
NPI enumeratedFebruary 20, 2015
Last updated in NPPESMarch 5, 2024
Certification dateFebruary 26, 2024
Mailing address15245 Shady Grove Rd, Suite 370, Rockville, MD 20850-3222

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