Provider Demographics
NPI:1720340532
Name:AJAVON, DEDE DELA
Entity Type:Individual
Prefix:
First Name:DEDE
Middle Name:DELA
Last Name:AJAVON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 QUEBEC TER
Mailing Address - Street 2:# 330
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-3109
Mailing Address - Country:US
Mailing Address - Phone:240-274-9919
Mailing Address - Fax:
Practice Address - Street 1:5101 WISCONSIN AVE NW
Practice Address - Street 2:# 250
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4120
Practice Address - Country:US
Practice Address - Phone:202-526-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide