Provider Demographics
NPI:1730159252
Name:DAKEN, JOHN S (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:DAKEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:S
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8455 COLESVILLE RD
Mailing Address - Street 2:SUITE 1025
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3396
Mailing Address - Country:US
Mailing Address - Phone:301-608-9205
Mailing Address - Fax:301-608-0146
Practice Address - Street 1:8455 COLESVILLE RD
Practice Address - Street 2:SUITE 1025
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3396
Practice Address - Country:US
Practice Address - Phone:301-608-9205
Practice Address - Fax:301-608-0146
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00582832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD143902Medicare PIN