Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Djavan Wharton-Lake

Individual provider Endodontics · NPI 1174938906

Djavan Wharton-Lake is an Endodontics in Hyattsville, Maryland. Practices as a sole proprietor. Licensed in California, Maryland, South Carolina and Virginia.

Licensed in
CA, MD, SC, VA
In the registry since
2014
Specialties on file
4

Practice location Address checks out

2045 University Blvd E Ste 204
Hyattsville, MD 20783-4137
Phone: (626) 254-0207
Fax: (626) 254-8679
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Endodontics (primary) Taxonomy 1223E0200X · Licence 0401417776 (VA)
Endodontics Taxonomy 1223E0200X · Licence 65036 (CA)
Endodontics Taxonomy 1223E0200X · Licence DGD.10963DS (SC)
Endodontics Taxonomy 1223E0200X · Licence 17787 (MD)

Record details

NPI number1174938906
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 1, 2014
Last updated in NPPESNovember 19, 2024
Certification dateNovember 19, 2024

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