Provider Demographics
NPI:1295993301
Name:DUAN, JIANMING (DMD)
Entity type:Individual
Prefix:DR
First Name:JIANMING
Middle Name:
Last Name:DUAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 S WASHINGTON ST
Mailing Address - Street 2:STE 200
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2335
Mailing Address - Country:US
Mailing Address - Phone:301-340-0313
Mailing Address - Fax:301-340-8182
Practice Address - Street 1:77 S WASHINGTON ST
Practice Address - Street 2:STE 200
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2335
Practice Address - Country:US
Practice Address - Phone:301-340-0313
Practice Address - Fax:301-340-8182
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-26
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD140871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice