Provider Demographics
NPI:1922535657
Name:CHORVINSKY, JESSICA ALLISON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ALLISON
Last Name:CHORVINSKY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ALLISON
Other - Last Name:GOODMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12520 PROSPERITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1664
Mailing Address - Country:US
Mailing Address - Phone:301-989-8994
Mailing Address - Fax:301-989-2434
Practice Address - Street 1:12520 PROSPERITY DR STE 300
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1664
Practice Address - Country:US
Practice Address - Phone:301-989-8994
Practice Address - Fax:301-989-2434
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD163781223P0221X
VA0401415578122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist