1093060147 NPI number — ALL SMILES DENTAL OF FALLS CHURCH, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093060147 NPI number — ALL SMILES DENTAL OF FALLS CHURCH, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL SMILES DENTAL OF FALLS CHURCH, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093060147
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6400 K SEVEN CORNERS PL
Provider Second Line Business Mailing Address:
ALL SMILES DENTAL OF FALLS CHURCH, PLLC
Provider Business Mailing Address City Name:
FALLS CHURCH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-237-7820
Provider Business Mailing Address Fax Number:
703-237-6699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6400 K SEVEN CORNERS PL
Provider Second Line Business Practice Location Address:
ALL SMILES DENTAL OF FALLS CHURCH, PLLC
Provider Business Practice Location Address City Name:
FALLS CHURCH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-237-7820
Provider Business Practice Location Address Fax Number:
703-237-6699
Provider Enumeration Date:
07/16/2012

Additional Information

Authorized Official

Authorized Official Last Name:
PHAM
Authorized Official First Name:
THANG
Authorized Official Middle Name:
BA
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
703-237-7820

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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