Provider Demographics
NPI:1477806024
Name:DR JOHN T DANIELS II DDS PC
Entity Type:Organization
Organization Name:DR JOHN T DANIELS II DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-271-5665
Mailing Address - Street 1:5001 5TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-4044
Mailing Address - Country:US
Mailing Address - Phone:202-723-8777
Mailing Address - Fax:
Practice Address - Street 1:5001 5TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4044
Practice Address - Country:US
Practice Address - Phone:202-723-8777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14023261QD0000X
VA0401411980261QD0000X
DC1000695261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental