Provider Demographics
NPI:1538216361
Name:RAJNIAK, JOHN D (LPC, DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:RAJNIAK
Suffix:
Gender:M
Credentials:LPC, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 MOBJACK LOOP
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-2613
Mailing Address - Country:US
Mailing Address - Phone:757-868-6480
Mailing Address - Fax:
Practice Address - Street 1:1657 MERRIMAC TRL
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5624
Practice Address - Country:US
Practice Address - Phone:757-220-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003769101YP2500X
VA04010081811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAOPTIMAOtherO85428M
VA360843OtherMANAGED HEALTH NET
VA180340OtherANTHEM