Provider Demographics
NPI:1386246494
Name:WASHINGTON, DOMINIQUE ANN
Entity type:Individual
Prefix:MS
First Name:DOMINIQUE
Middle Name:ANN
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 OAK ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2504
Mailing Address - Country:US
Mailing Address - Phone:513-984-1800
Mailing Address - Fax:513-984-4909
Practice Address - Street 1:411 OAK ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2504
Practice Address - Country:US
Practice Address - Phone:513-984-1800
Practice Address - Fax:513-984-4909
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant