1811365976 NPI number — ARLINGTON CITY DENTAL ASSOCIATES PLLC

Table of content: (NPI 1811365976)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811365976 NPI number — ARLINGTON CITY DENTAL ASSOCIATES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARLINGTON CITY DENTAL ASSOCIATES PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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NPI Number Information

NPI Number:
1811365976
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1425 S EADS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22202-2847
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
857-234-9132
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1425 S EADS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22202-2847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
857-234-9132
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/07/2015

Additional Information

Authorized Official

Authorized Official Last Name:
KAUR
Authorized Official First Name:
AJINDER
Authorized Official Middle Name:
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
857-234-9132

Provider Taxonomy Codes

  • Taxonomy code: 305R00000X , with the licence number:  0401414540 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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