Provider Demographics
NPI:1366679706
Name:CALDWELL, JARRETT (PHARMD, DDS)
Entity Type:Individual
Prefix:DR
First Name:JARRETT
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:PHARMD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 INGRAHAM ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-7707
Mailing Address - Country:US
Mailing Address - Phone:202-669-6571
Mailing Address - Fax:
Practice Address - Street 1:2012 HECHT AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1668
Practice Address - Country:US
Practice Address - Phone:202-669-6571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10018721223X0400X, 1223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics