Provider Demographics
NPI:1285821512
Name:JEFFREY HIRSCH DDS
Entity Type:Organization
Organization Name:JEFFREY HIRSCH DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-774-4930
Mailing Address - Street 1:18121 GEORGIA AVE
Mailing Address - Street 2:STE #108
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832
Mailing Address - Country:US
Mailing Address - Phone:301-774-4930
Mailing Address - Fax:301-774-4937
Practice Address - Street 1:18121 GEORGIA AVE
Practice Address - Street 2:STE #108
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832
Practice Address - Country:US
Practice Address - Phone:301-774-4930
Practice Address - Fax:301-774-4937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10855122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty