Healthcare Provider Details
I. General information
NPI: 1033279575
Provider Name (Legal Business Name): ARLINGTON DENTAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/12/2006
Last Update Date: 09/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6060 ARLINGTON BLVD
FALLS CHURCH VA
22044-2943
US
IV. Provider business mailing address
PO BOX 7186
ARLINGTON VA
22207-0186
US
V. Phone/Fax
- Phone: 703-587-3455
- Fax:
- Phone: 703-587-3455
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0300X |
| Taxonomy | Periodontics |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HOMAN
SOLEMANINEJAD
Title or Position: DOCTOR
Credential: DMD
Phone: 703-587-3455