Provider Demographics
NPI:1811187172
Name:BURKES, JASON NEAL (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:NEAL
Last Name:BURKES
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 OAK TREE RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-8216
Mailing Address - Country:US
Mailing Address - Phone:248-495-0519
Mailing Address - Fax:
Practice Address - Street 1:WRNMMC ORAL & MAXILLOFACIAL SURGERY
Practice Address - Street 2:8901 WISCONSIN AVE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-4917
Practice Address - Country:US
Practice Address - Phone:301-295-4340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 18021122300000X
TX25879122300000X
VA04380003961223S0112X
TXQ4372204E00000X
VA0101266069204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No122300000XDental ProvidersDentist
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery