Provider Demographics
NPI:1114136777
Name:ROCHELLE J, LEPOR, LLC
Entity Type:Organization
Organization Name:ROCHELLE J, LEPOR, LLC
Other - Org Name:BRIGGS CHANEY FAMILY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEPOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-890-8005
Mailing Address - Street 1:13823 OUTLET DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4971
Mailing Address - Country:US
Mailing Address - Phone:301-890-8005
Mailing Address - Fax:
Practice Address - Street 1:13823 OUTLET DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4971
Practice Address - Country:US
Practice Address - Phone:301-890-8005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty