Provider Demographics
NPI:1265890305
Name:SLOTKOFF, XAVIER
Entity type:Individual
Prefix:
First Name:XAVIER
Middle Name:
Last Name:SLOTKOFF
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 1:1712 I ST NW
Mailing Address - Street 2:SUITE 514
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-3702
Mailing Address - Country:US
Mailing Address - Phone:202-857-0016
Mailing Address - Fax:
Practice Address - Street 1:1712 I ST NW
Practice Address - Street 2:SUITE 514
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3702
Practice Address - Country:US
Practice Address - Phone:202-857-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN43091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice