1821137738 NPI number — JOANNE CRENSHAW, MD PC

Table of content: GREGORY OHANIAN D.D.S., M.S. (NPI 1518210772)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821137738 NPI number — JOANNE CRENSHAW, MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOANNE CRENSHAW, MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821137738
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
47568 ANCHORAGE CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POTOMAC FALLS
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20165-4712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-421-2875
Provider Business Mailing Address Fax Number:
703-421-5701

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21135 WHITFIELD PLACE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
STERLING
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20165-7279
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-766-6165
Provider Business Practice Location Address Fax Number:
703-444-4985
Provider Enumeration Date:
02/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CRENSHAW
Authorized Official First Name:
JOANNE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
703-766-6165

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  0101057318 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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