Healthcare Provider Details

I. General information

NPI: 1588576458
Provider Name (Legal Business Name): DENTAL GROUP OF LOUDOUN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44345 PREMIER PLZ STE 220
ASHBURN VA
20147-5054
US

IV. Provider business mailing address

44345 PREMIER PLZ STE 220
ASHBURN VA
20147-5054
US

V. Phone/Fax

Practice location:
  • Phone: 443-980-8263
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: LILIA SEMEREY
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 443-980-8263