Provider Demographics
NPI:1639411663
Name:MOORE, DAYNA LEIGH
Entity Type:Individual
Prefix:
First Name:DAYNA
Middle Name:LEIGH
Last Name:MOORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAYNA
Other - Middle Name:LEIGH
Other - Last Name:LINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2339 LONDON BRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5762
Mailing Address - Country:US
Mailing Address - Phone:703-328-1460
Mailing Address - Fax:
Practice Address - Street 1:2339 LONDON BRIDGE DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-5762
Practice Address - Country:US
Practice Address - Phone:703-328-1460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant