JULIA LYNN COLLAZO (NPI# 1366094294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366094294 |
| Entity Type | Individual |
| Full Name | JULIA LYNN COLLAZO |
| Credential | DMD |
| Practice Address |
8901 Wisconsin Avenue Building 9, 2nd Floor Bethesda MD 20889 |
| Mailing Address |
4528 Windsor Ln Bethesda MD 20814-4725 |
| Practice Telephone | 3014002060 |
| Mailing Telephone | 3524006069 |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-07-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN24225 | FL | Dental Providers |
| Street Address |
8901 WISCONSIN AVENUE BUILDING 9, 2ND FLOOR |
| City | BETHESDA |
| State | MD |
| Zip Code | 20889 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417951088 | Daniel Ricardo Elizondo | Ophthalmology | 8901 Wisconsin Avenue, Bethesda, MD 20889-5000 | 2005-06-10 |
| 1801418439 | Walter Guillory II | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2020-05-18 |
| 1952920720 | Aditya Patel | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Avenue, Walter Reed Military Medical Center, Bethesda, MD 20889-0001 | 2020-04-13 |
| 1417410515 | Samuel Woodle | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Avenue, Walter Reed Neurosurgery Residency, Bethesda, MD 20889 | 2019-04-08 |
| 1508328808 | Benjamin Ficke | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Avenue, Walter Reed National Medical Center, Bethesda, MD 20889-0001 | 2019-04-04 |
| 1740763093 | Kattie Khadar | Nurse Practitioner | 8901 Wisconsin Avenue, Bethesda, MD 20814 | 2018-09-12 |
| 1528559945 | Jonathan David Vignali | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2018-05-21 |
| 1669974150 | Maria Park | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Avenue, Pediatrics Walter Reed National Military Medical Center, Bethesda, MD 20889 | 2018-03-01 |
| 1265933949 | Amanda Cain | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Avenue, Walter Reed National Military Medical Center, Bethesda, MD 20889 | 2018-02-27 |
| 1437688793 | Jonathan Bui | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2017-06-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457987034 | Michael Franco | Student in an Organized Health Care Education/Training Program | Internal Medicine - Walter Reed Nmmc, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2020-03-16 |
| 1245862135 | Kay Tomashek | Pediatrics | National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889 | 2020-02-07 |
| 1104470657 | Adam Pink | Dentist | 8901 Wisconsin Ave Building 9 Floor 2, Bethesda, MD 20889 | 2019-08-01 |
| 1659939155 | Matthew Heller | Student in an Organized Health Care Education/Training Program | Psychiatry Walter Reed National Military Medica, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2019-05-30 |
| 1891258034 | Jane Ann Crotteau | Student in an Organized Health Care Education/Training Program | Pediatrics Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2019-04-12 |
| 1417434341 | Andrea Baeder | Dentist | 8901 Wisconsin Ave Bldg 9, Floor 2, Bethesda, AA 20889 | 2018-07-24 |
| 1942741723 | John Vance | Orthotist | Wrnmmc Orthotics, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2017-03-14 |
| 1790225704 | Sylvia Best | Pharmacist | 8901 Wisconsin Avenue Wrnmmc-, Americas Building 19- Internal Medicine Suite 2820, Bethesda, MD 20889 | 2017-02-24 |
| 1255783767 | Ryan Kaye | Student in an Organized Health Care Education/Training Program | Nsa Bethesda, 8901 Wisconsin Ave, Bethesda, Md 20889, Fpo, AA 20889 | 2016-07-08 |
| 1366861221 | Tara Elizabeth Brown | Internal Medicine | 8901 Wisconsin Avenue Walter Reed Nmmc, Bethesda, MD 20889 | 2014-04-08 |
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| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972135291 | Super Smile Center of Bethesda | Dentist | 10320 Westlake Dr., Suite# 109, Bethesda, MD 20817 | 2020-02-05 |
| 1518516194 | Drake Winslow Williams | Dentist | 10 Center Dr Rm 1b01, Bethesda, MD 20892-0001 | 2019-09-06 |
| 1003388612 | Marie Kao-hsieh | Dentist | 10 Center Dr Room 1n117a, Bethesda, MD 20892-0001 | 2018-12-20 |
| 1689160921 | Peter Joung Hoon Lee | Dentist | 8901 Wisconsin Ave Fl 2, Bethesda, MD 20889-0004 | 2018-07-10 |
| 1942619457 | Pamela Gardner | Dentist | Nih Nidcr Dental Clinic, 10 Center Drive, 10/1n117, Bethesda, MD 20892-0001 | 2014-08-08 |
| 1164843785 | Jonathan A Morris Dds, PC | Dentist | 8218 Wisconsin Ave Ste 404, Bethesda, MD 20814-3107 | 2013-12-27 |
| 1427480151 | William Sidney Blackmore | Dentist | 9222 E Parkhill Dr, Bethesda, MD 20814-3949 | 2013-08-05 |
| 1538509393 | Christopher Joseph Puglisi | Dentist | 2 Ardmore Ct, Bethesda, MD 20816-2015 | 2013-06-26 |
| 1578844965 | Michael Bradford Harper | Dentist | Walter Reed Natl Military Ctr, Bldg # 17 Room # 3140, Bethesda, MD 20889-5600 | 2011-08-30 |
| 1669760195 | Divine Smiles Dentistry | Dentist | 8001 Wisconsin Ave, Suite 103, Bethesda, MD 20814-3602 | 2011-07-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.