MEDICARE: DR. TARASHA PEARSON DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	0401412558	VA
2	122300000X	Dentist	DEN1000833	DC
3	1223P0221X	Pediatric Dentistry	DEN1000833	DC

General Provider Information

NPI Number	:	1134197460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARASHA PEARSON DDS

Provider Business Mailing Address
First Line	:	4357 HUNTLEY CT
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-5111
Country	:	US
Telephone Number	:	703-583-1635
Fax Number	:	703-583-1635

Provider Business Practice Location Address
First Line	:	2041 MARTIN LUTHER KING JR AVE SE
Second Line	:	SUITE M11
City	:	WASHINGTON
State	:	DC
Zip	:	20020-7024
Country	:	US
Telephone Number	:	202-889-5200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2006
Last Update Date	:	07/01/2020

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