Provider Demographics
NPI:1639278484
Name:GREENWALD, DANA SUE (DDS)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:SUE
Last Name:GREENWALD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5225 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 604
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2014
Mailing Address - Country:US
Mailing Address - Phone:202-966-0045
Mailing Address - Fax:202-364-1386
Practice Address - Street 1:5225 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 604
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2014
Practice Address - Country:US
Practice Address - Phone:202-966-0045
Practice Address - Fax:202-364-1386
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DC52601223P0221X
MD103711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry