Provider Demographics
NPI:1558415810
Name:JENKINS, TAUNYA LAWAN (DDS)
Entity Type:Individual
Prefix:
First Name:TAUNYA
Middle Name:LAWAN
Last Name:JENKINS
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 1:6525 BELCREST RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2003
Mailing Address - Country:US
Mailing Address - Phone:301-779-0522
Mailing Address - Fax:301-927-1815
Practice Address - Street 1:6525 BELCREST RD
Practice Address - Street 2:SUITE 201
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-2003
Practice Address - Country:US
Practice Address - Phone:301-779-0522
Practice Address - Fax:301-927-1815
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD135371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice