Provider Demographics
NPI:1548570674
Name:DUFERA, DANIEL AYANA (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:AYANA
Last Name:DUFERA
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 1:921B ELLSWORTH DRIVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4478
Mailing Address - Country:US
Mailing Address - Phone:301-588-5400
Mailing Address - Fax:301-588-6454
Practice Address - Street 1:921B ELLSWORTH DRIVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4478
Practice Address - Country:US
Practice Address - Phone:301-588-5400
Practice Address - Fax:301-588-6454
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055019122300000X
MD14480122300000X
NJ22D102449600122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist