Provider Demographics
NPI:1871873273
Name:WASHINGTON, JUSTIN HOWARD (DDS, MPH)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:HOWARD
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 CAROLINE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-5715
Mailing Address - Country:US
Mailing Address - Phone:832-489-4677
Mailing Address - Fax:
Practice Address - Street 1:5009 CAROLINE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5715
Practice Address - Country:US
Practice Address - Phone:832-489-4677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27347122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist