MEDICARE: SPRINGFIELD ENDODONTICS

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	1223E0200X	Endodontics

General Provider Information

NPI Number	:	1841000239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRINGFIELD ENDODONTICS

Provider Business Mailing Address
First Line	:	43145 VALIANT DR
Second Line	:
City	:	CHANTILLY
State	:	VA
Zip	:	20152-3423
Country	:	US
Telephone Number	:	317-989-9730
Fax Number	:

Provider Business Practice Location Address
First Line	:	7426 ALBAN STATION BLVD STE B202
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-2323
Country	:	US
Telephone Number	:	317-989-9730
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANMAR AL-JANABI
Credential	:	DDS, MSD, MSC
Telephone Number	:	571-303-0313

Provider Enumeration Date	:	01/09/2025
Last Update Date	:	01/13/2025

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Directions to “SPRINGFIELD ENDODONTICS ” Practice Location

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