Healthcare Provider Details

I. General information

NPI: 1467763433
Provider Name (Legal Business Name): JANA LAKIM MCCALL D.D.S, M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANA LAKIM MCCALL D.D.S, M.S.

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11175 GEORGIA AVE
WHEATON MD
20902-4605
US

IV. Provider business mailing address

10926 DAPPLED GREY WAY
UPPER MARLBORO MD
20772-8307
US

V. Phone/Fax

Practice location:
  • Phone: 301-933-5175
  • Fax:
Mailing address:
  • Phone: 770-356-4138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number14564
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: