Provider Demographics
NPI:1013010065
Name:DONAHUE, JAMES JOHN JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOHN
Last Name:DONAHUE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 OSAGE ST
Mailing Address - Street 2:STE 102
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-2607
Mailing Address - Country:US
Mailing Address - Phone:703-998-6558
Mailing Address - Fax:703-998-7278
Practice Address - Street 1:1707 OSAGE ST
Practice Address - Street 2:STE 102
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-2607
Practice Address - Country:US
Practice Address - Phone:703-998-6558
Practice Address - Fax:703-998-7278
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3713122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist