Healthcare Provider Details

I. General information

NPI: 1851102602
Provider Name (Legal Business Name): JANET YASUDA DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 NEW MEXICO AVE NW STE 123
WASHINGTON DC
20016-3622
US

IV. Provider business mailing address

3301 NEW MEXICO AVE NW STE 123
WASHINGTON DC
20016-3622
US

V. Phone/Fax

Practice location:
  • Phone: 202-350-2610
  • Fax: 202-935-2612
Mailing address:
  • Phone: 202-350-2610
  • Fax: 202-935-2612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JANET YASUDA
Title or Position: OWNER
Credential: DMD, MS
Phone: 202-350-2610