Provider Demographics
NPI:1508004318
Name:HAWKINS, JENNY OWENS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:OWENS
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22749 MAPLE ROAD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653
Mailing Address - Country:US
Mailing Address - Phone:301-863-8822
Mailing Address - Fax:301-866-0760
Practice Address - Street 1:22749 MAPLE ROAD
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653
Practice Address - Country:US
Practice Address - Phone:301-863-8822
Practice Address - Fax:301-866-0760
Is Sole Proprietor?:No
Enumeration Date:2009-02-02
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14188122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist