Healthcare Provider Details

I. General information

NPI: 1295129294
Provider Name (Legal Business Name): BRITTANY P SMIRNOV DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRITTANY P FRANK DO

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 10/13/2022
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 ARLINGTON BLVD STE 102
FALLS CHURCH VA
22042-3000
US

IV. Provider business mailing address

6565 ARLINGTON BLVD STE 102
FALLS CHURCH VA
22042-3000
US

V. Phone/Fax

Practice location:
  • Phone: 703-578-1770
  • Fax: 703-820-7088
Mailing address:
  • Phone: 703-578-1770
  • Fax: 703-820-7088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberOS14093
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOS 14093
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number0102206515
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: