Healthcare Provider Details

I. General information

NPI: 1508113812
Provider Name (Legal Business Name): DANIEL JEFFREY DEUTSCH DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 K STREET, NW 8 FLOOR
WASHINGTON DC
20005
US

IV. Provider business mailing address

1430 K STREET, NW 8 FLOOR
WASHINGTON DC
20005
US

V. Phone/Fax

Practice location:
  • Phone: 202-223-6630
  • Fax: 202-467-0690
Mailing address:
  • Phone: 202-223-6630
  • Fax: 202-467-0690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2854
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: