Provider Demographics
NPI:1902008543
Name:KING, CHRISTIAN ADEOLA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:ADEOLA
Last Name:KING
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 1:10907 ADLER CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5735
Mailing Address - Country:US
Mailing Address - Phone:301-333-4741
Mailing Address - Fax:301-333-4742
Practice Address - Street 1:HOWARD UNIVERSITY HOSPITAL
Practice Address - Street 2:2041 GEORGIA AVE NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060-0001
Practice Address - Country:US
Practice Address - Phone:202-865-1491
Practice Address - Fax:202-865-4849
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN37731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCDEN3773OtherDENTAL LICENSE
MD7372OtherDENTAL LICENSE