TJB OF DULLES LLC NPI 1457720302

NPI Information

NPI: 1457720302
Provider Name: TJB OF DULLES, LLC

Doing Business As: LOUDOUN DENTAL ASSOCIATES & SMILEZ PEDIATRIC DENTAL GROUP

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
24565 DULLES LANDING DR
SUITE 190
DULLES, VA
ZIP 20166
Phone: (703) 468-0188
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TJB OF DULLES, LLC is a dental clinic center in Dulles, VA. TJB OF DULLES, LLC NPI is 1457720302. The provider is registered as an organization entity type.
The provider Is Doing Business As Loudoun Dental Associates & Smilez Pediatric Dental Group.

The provider's business location address is:

24565 DULLES LANDING DR
SUITE 190
DULLES, VA
ZIP 20166-612
Phone: (703) 468-0188
Fax: (703) 754-1694

The provider's authorized official is Kerri Nichols .
The authorized official title is Regional Director and has the following contact phone number (540) 494-8776.

The enumeration date for this NPI number is 9/22/2015 and was last updated on 9/22/2015.

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
1	261QD0000X	Clinic/Center	Dental	0401410720	VIRGINIA	No
2	261QD0000X	Clinic/Center	Dental	0401007652	VIRGINIA	Yes

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

NPI Synchronization or Removal

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