Provider Demographics
NPI:1093950933
Name:WINFREE, WILLIE JERONE (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIE
Middle Name:JERONE
Last Name:WINFREE
Suffix:
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 1:600 W ST NW
Mailing Address - Street 2:ROOM 317
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20059-0001
Mailing Address - Country:US
Mailing Address - Phone:202-806-0037
Mailing Address - Fax:
Practice Address - Street 1:600 W ST NW
Practice Address - Street 2:ROOM 317
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20059-0001
Practice Address - Country:US
Practice Address - Phone:202-806-0037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC38181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice