Provider Demographics
NPI:1649261637
Name:ROONEY, DANIEL DARE (DO)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:DARE
Last Name:ROONEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PARK ST SE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4644
Mailing Address - Country:US
Mailing Address - Phone:703-281-2266
Mailing Address - Fax:703-281-1678
Practice Address - Street 1:201 PARK ST SE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4644
Practice Address - Country:US
Practice Address - Phone:703-281-2266
Practice Address - Fax:703-281-1678
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102021665207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5648734Medicaid
VAB93695Medicare UPIN
VAR0153322Medicare ID - Type Unspecified