Provider Demographics
NPI:1205938503
Name:CHAFFIN, JEFFREY (DDS, MPH, MBA, MHA)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:CHAFFIN
Suffix:
Gender:M
Credentials:DDS, MPH, MBA, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SCOTLAND CIR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-7612
Mailing Address - Country:US
Mailing Address - Phone:989-659-6898
Mailing Address - Fax:
Practice Address - Street 1:5109 LEESBURG PIKE
Practice Address - Street 2:SUITE 682 OFFICE OF THE SURGEON GNERAL, DASG-DC
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041
Practice Address - Country:US
Practice Address - Phone:703-681-3031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010170881223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health