Healthcare Provider Details

I. General information

NPI: 1689712168
Provider Name (Legal Business Name): ABDUL KARIM JADUN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 03/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 RHODE ISLAND AVE NE
WASHINGTON DC
20018-2966
US

IV. Provider business mailing address

2802 RHODE ISLAND AVE NE
WASHINGTON DC
20018-2966
US

V. Phone/Fax

Practice location:
  • Phone: 202-269-3387
  • Fax: 202-269-4814
Mailing address:
  • Phone: 202-269-3387
  • Fax: 202-269-4814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4438
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: