Healthcare Provider Details

I. General information

NPI: 1326163320
Provider Name (Legal Business Name): JESSICA EXELBERT RUBIN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 WISCONSIN AVE NW SUITE 240
WASHINGTON DC
20016-2143
US

IV. Provider business mailing address

4200 WISCONSIN AVE NW SUITE 240
WASHINGTON DC
20016-2143
US

V. Phone/Fax

Practice location:
  • Phone: 202-545-7200
  • Fax: 202-545-7220
Mailing address:
  • Phone: 202-545-7200
  • Fax: 202-545-7220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDEN1000864
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: