Provider Demographics
NPI:1871012278
Name:MCLENNAN, JAHNELLE DANICA (DDS)
Entity Type:Individual
Prefix:
First Name:JAHNELLE
Middle Name:DANICA
Last Name:MCLENNAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SHAWAN RD STE 2
Mailing Address - Street 2:
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21030-1373
Mailing Address - Country:US
Mailing Address - Phone:410-891-8547
Mailing Address - Fax:443-281-8320
Practice Address - Street 1:5 SHAWAN RD STE 2
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21030
Practice Address - Country:US
Practice Address - Phone:410-891-8547
Practice Address - Fax:443-281-8320
Is Sole Proprietor?:No
Enumeration Date:2017-09-17
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1001769122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist