Provider Demographics
NPI:1457499329
Name:BRAMWELL, JOHN DOUGLAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DOUGLAS
Last Name:BRAMWELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 OAK SHADOW DR
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-4200
Mailing Address - Country:US
Mailing Address - Phone:703-860-9182
Mailing Address - Fax:
Practice Address - Street 1:11359 SUNSET HILLS RD
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5275
Practice Address - Country:US
Practice Address - Phone:703-437-6666
Practice Address - Fax:703-435-8281
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA49861223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics