Provider Demographics
NPI:1659417541
Name:ALLEN, DONALD RAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RAY
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 ARAGONA BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4243
Mailing Address - Country:US
Mailing Address - Phone:301-292-5448
Mailing Address - Fax:
Practice Address - Street 1:1990 K ST NW
Practice Address - Street 2:SUITE 15A
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1103
Practice Address - Country:US
Practice Address - Phone:202-775-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN52241223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics