Provider Demographics
NPI:1548555758
Name:TAWAKALI, LAJOYOUS SALIEA (DDS)
Entity Type:Individual
Prefix:
First Name:LAJOYOUS
Middle Name:SALIEA
Last Name:TAWAKALI
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 1:5455 16TH AVE
Mailing Address - Street 2:UNIT T4
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3427
Mailing Address - Country:US
Mailing Address - Phone:240-528-1511
Mailing Address - Fax:
Practice Address - Street 1:1900 MASSACHUSETTS AVE SE
Practice Address - Street 2:BUILDING 29
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2542
Practice Address - Country:US
Practice Address - Phone:202-548-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1001214122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist