Healthcare Provider Details

I. General information

NPI: 1659752590
Provider Name (Legal Business Name): JENNY RHEE D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6120 EXECUTIVE BLVD STE 210
ROCKVILLE MD
20852-4942
US

IV. Provider business mailing address

6120 EXECUTIVE BLVD STE 210
ROCKVILLE MD
20852-4942
US

V. Phone/Fax

Practice location:
  • Phone: 240-669-8647
  • Fax:
Mailing address:
  • Phone: 240-669-8647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number15863
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: