Provider Demographics
NPI:1326163320
Name:RUBIN, JESSICA EXELBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:EXELBERT
Last Name:RUBIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4200 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 240
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2143
Mailing Address - Country:US
Mailing Address - Phone:202-545-7200
Mailing Address - Fax:202-545-7220
Practice Address - Street 1:4200 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 240
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2143
Practice Address - Country:US
Practice Address - Phone:202-545-7200
Practice Address - Fax:202-545-7220
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD139791223P0221X
DCDEN10008641223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC057018600Medicaid