Provider Demographics
NPI:1225184229
Name:O'LEARY, DENNIS SOPHIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:SOPHIAN
Last Name:O'LEARY
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 1:5840 MACARTHUR BLVD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2542
Mailing Address - Country:US
Mailing Address - Phone:202-966-8108
Mailing Address - Fax:202-966-8106
Practice Address - Street 1:5840 MACARTHUR BLVD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2542
Practice Address - Country:US
Practice Address - Phone:202-966-8108
Practice Address - Fax:202-966-8106
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC58171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice