Healthcare Provider Details

I. General information

NPI: 1033975388
Provider Name (Legal Business Name): JANEL RENE ROBINSON RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANEL RENE BURGAN RDH

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 02/26/2024
Certification Date: 02/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7360 GUILFORD DR STE 102
FREDERICK MD
21704-5128
US

IV. Provider business mailing address

111 S BROAD ST
WAYNESBORO PA
17268-1612
US

V. Phone/Fax

Practice location:
  • Phone: 301-668-2662
  • Fax:
Mailing address:
  • Phone: 240-291-2907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number4554
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: