Healthcare Provider Details

I. General information

NPI: 1306727938
Provider Name (Legal Business Name): SMILES OF VA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7115 LEESBURG PIKE STE 320
FALLS CHURCH VA
22043-2301
US

IV. Provider business mailing address

20380 MEDALIST DR
ASHBURN VA
20147-4186
US

V. Phone/Fax

Practice location:
  • Phone: 703-533-1733
  • Fax:
Mailing address:
  • Phone: 703-999-8208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: ANURADHA BERI
Title or Position: OWNER
Credential: BDS, CAGS, MSD
Phone: 703-999-8208