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PEARLY WHITES FAMILY DENTAL NPI 1114357498


NPI Information

NPI: 1114357498
Provider Name: PEARLY WHITES FAMILY DENTAL
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
7227 COMMERCE ST
SPRINGFIELD, VA
ZIP 22150
Phone: (703) 992-7778
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PEARLY WHITES FAMILY DENTAL is a general practice dentist in Springfield, VA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. PEARLY WHITES FAMILY DENTAL NPI is 1114357498. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7227 COMMERCE ST
SPRINGFIELD, VA
ZIP 22150-411
Phone: (703) 992-7778
Fax: (571) 565-2204

The provider's authorized official is Agustina N Mustafa .
The authorized official title is Office Manager and has the following contact phone number (703) 992-7778.

The enumeration date for this NPI number is 11/22/2013 and was last updated on 12/28/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice04014713726VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1=========MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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