Organization
H. CHARLES JELINEK JR. D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALLISON PLATT (OFFICE ADMINISTRATOR)
(703) 560-8700
Entity
Organization
Contact information
Practice address
8505 ARLINGTON BLVD., STE. 260, FAIRFAX, VA 22031
(703) 560-8700
(703) 560-1745
Mailing address
8505 ARLINGTON BLVD., STE. 260, FAIRFAX, VA 22031
(703) 560-8700
(703) 560-1745
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
0401007079
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7394890001
MEDICARE PTAN
VA
Enumeration date
04/29/2016
Last updated
04/29/2016
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