MEDICARE: DR. DONNA REID 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	1223G0001X	General Practice Dentistry	0401411050	VA

General Provider Information

NPI Number	:	1235235425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONNA REID DDS

Provider Business Mailing Address
First Line	:	6712 SULLIVAN WAY
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22315-6078
Country	:	US
Telephone Number	:	571-970-4103
Fax Number	:	571-970-4116

Provider Business Practice Location Address
First Line	:	300 N WASHINGTON ST
Second Line	:	SUITE 210
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-2530
Country	:	US
Telephone Number	:	703-653-4452
Fax Number	:	571-970-4116

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	01/11/2016

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Directions to “ DR. DONNA REID DDS” Practice Location

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