Provider Demographics
NPI:1629056676
Name:DESCHENES, RANEY JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:RANEY
Middle Name:JAMES
Last Name:DESCHENES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMDT(CG-1122), US COAST GUARD
Mailing Address - Street 2:2100 2ND ST. SW, SUITE 5314
Mailing Address - City:WASHINGTON,
Mailing Address - State:DC
Mailing Address - Zip Code:20593
Mailing Address - Country:US
Mailing Address - Phone:202-267-0801
Mailing Address - Fax:202-326-7468
Practice Address - Street 1:COMDT(CG-1122), US COAST GUARD
Practice Address - Street 2:2100 2ND ST. SW, SUITE 5314
Practice Address - City:WASHINGTON,
Practice Address - State:DC
Practice Address - Zip Code:20593
Practice Address - Country:US
Practice Address - Phone:202-267-0801
Practice Address - Fax:202-326-7468
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150451223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics