Provider Demographics
NPI:1417732405
Name:WASHINGTON, ANGELA YANAE (DDS)
Entity Type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:YANAE
Last Name:WASHINGTON
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 1:9407 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-8003
Mailing Address - Country:US
Mailing Address - Phone:901-309-6821
Mailing Address - Fax:
Practice Address - Street 1:9407 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-8003
Practice Address - Country:US
Practice Address - Phone:901-309-6821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12307122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist