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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DJAVAN WHARTON-LAKE

Active Sole Proprietor

DJAVAN WHARTON-LAKE is a Endodontics healthcare provider located in HYATTSVILLE, Maryland. NPI 1174938906 is currently active in the NPPES registry. Verify at CMS.

Endodontics · HYATTSVILLE, MD

Registration Details

NPI Number
1174938906
Provider Type
Individual
Gender
Male
NPI Issued
Jul 1, 2014 (12.098241129841 yrs)
Last Updated
Nov 19, 2024
Licenses
65036 (CA)
DGD.10963DS (SC)
17787 (MD)
0401417776 (VA)
Sole Proprietor
Yes

Practice Information

Address
2045 UNIVERSITY BLVD E STE 204
HYATTSVILLE, MD, 207834137
Browse MD providers · Browse ZIP 20783
Phone
6262540207
Fax
6262548679
Primary Specialty
Endodontics
1223E0200X
Additional Specialty
Endodontics
Additional Specialty
Endodontics
Additional Specialty
Endodontics

Other Endodontics Providers in HYATTSVILLE, MD

Name Credential NPI
DR. SHAHRYAR NASIR KHALIQ D.M.D. 1295141091
TANVIR SINGH 1477043230
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.