Provider Demographics
NPI:1316152184
Name:JELINEK, JAMES W (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:JELINEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ROCK POINTE LN
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2630
Mailing Address - Country:US
Mailing Address - Phone:540-349-0033
Mailing Address - Fax:540-347-5872
Practice Address - Street 1:60 ROCK POINTE LN
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2630
Practice Address - Country:US
Practice Address - Phone:540-349-0033
Practice Address - Fax:540-347-5872
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA6730122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA234019OtherANTHEM BCBS
VA817559OtherUNITED CONCORDIA
VA00606001OtherDELTA DENTAL