MEDICARE: HERITAGE HUNT DENTAL

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

General Provider Information

NPI Number	:	1790666113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERITAGE HUNT DENTAL

Provider Business Mailing Address
First Line	:	7100 HERITAGE VILLAGE PLZ STE 101
Second Line	:
City	:	GAINESVILLE
State	:	VA
Zip	:	20155-3066
Country	:	US
Telephone Number	:	703-754-5800
Fax Number	:	703-754-8119

Provider Business Practice Location Address
First Line	:	7100 HERITAGE VILLAGE PLZ STE 101
Second Line	:
City	:	GAINESVILLE
State	:	VA
Zip	:	20155-3066
Country	:	US
Telephone Number	:	703-754-5800
Fax Number	:	703-754-8119

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRIS HOUSER
Credential	:
Telephone Number	:	703-754-5800

Provider Enumeration Date	:	09/11/2025
Last Update Date	:	09/17/2025

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