Provider Demographics
NPI:1336119395
Name:DANKO, ERIC NMI (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:NMI
Last Name:DANKO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LOGAN DENTAL CLINIC
Mailing Address - Street 2:9225 DOERR RD
Mailing Address - City:FORT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-2204
Mailing Address - Country:US
Mailing Address - Phone:703-681-3034
Mailing Address - Fax:
Practice Address - Street 1:LOGAN DENTAL CLINIC
Practice Address - Street 2:9225 DOERR RD
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-2204
Practice Address - Country:US
Practice Address - Phone:036-813-0347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY80761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
BD8807058OtherFEDERAL DEA