Provider Demographics
NPI:1720635345
Name:POPA, BOGDAN NICOLAE (DMD)
Entity type:Individual
Prefix:
First Name:BOGDAN
Middle Name:NICOLAE
Last Name:POPA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WASHINGTON CIR NW STE G
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2326
Mailing Address - Country:US
Mailing Address - Phone:202-785-9474
Mailing Address - Fax:
Practice Address - Street 1:3 WASHINGTON CIR NW STE G
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2326
Practice Address - Country:US
Practice Address - Phone:202-785-9474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1002047122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty