Provider Demographics
NPI:1376809798
Name:ESI, EJIRO (DDS)
Entity Type:Individual
Prefix:DR
First Name:EJIRO
Middle Name:
Last Name:ESI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 S ARLINGTON MILL DR UNIT 711
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3409
Mailing Address - Country:US
Mailing Address - Phone:240-245-0540
Mailing Address - Fax:240-554-2532
Practice Address - Street 1:8170 MAPLE LAWN BLVD STE 150
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2564
Practice Address - Country:US
Practice Address - Phone:240-245-0540
Practice Address - Fax:240-554-2532
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD132481223X0400X
VA04014123361223X0400X
DCDEN10004081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics