Healthcare Provider Details

I. General information

NPI: 1669630091
Provider Name (Legal Business Name): DROR ORBACH DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WASHINGTON CIR NW SUITE 304
WASHINGTON DC
20037-2356
US

IV. Provider business mailing address

3 WASHINGTON CIR NW SUITE 304
WASHINGTON DC
20037-2356
US

V. Phone/Fax

Practice location:
  • Phone: 202-625-0888
  • Fax: 202-625-0888
Mailing address:
  • Phone: 202-625-0888
  • Fax: 202-625-0888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number0401412808
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDEN1001000
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: