Provider Demographics
NPI:1902419823
Name:DANTIGNAC, STEVEN ALLEN
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ALLEN
Last Name:DANTIGNAC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 P ST SW APT 502
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2921
Mailing Address - Country:US
Mailing Address - Phone:202-531-4108
Mailing Address - Fax:
Practice Address - Street 1:1520 BUTLER ST SE # 201
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4375
Practice Address - Country:US
Practice Address - Phone:202-568-2473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-29
Last Update Date:2020-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC22201583747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant