Provider Demographics
NPI:1851862940
Name:H. CHARLES JELINEK JR. DDS
Entity Type:Organization
Organization Name:H. CHARLES JELINEK JR. DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:PLATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-560-8700
Mailing Address - Street 1:8505 ARLINGTON BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4636
Mailing Address - Country:US
Mailing Address - Phone:703-560-8700
Mailing Address - Fax:
Practice Address - Street 1:8505 ARLINGTON BLVD STE 260
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4636
Practice Address - Country:US
Practice Address - Phone:703-560-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment