Healthcare Provider Details

I. General information

NPI: 1942756184
Provider Name (Legal Business Name): ALISA DILL D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 HERITAGE VILLAGE PLZ STE 101
GAINESVILLE VA
20155-3066
US

IV. Provider business mailing address

13177 PIEDMONT VISTA DR
HAYMARKET VA
20169-2643
US

V. Phone/Fax

Practice location:
  • Phone: 703-754-5800
  • Fax:
Mailing address:
  • Phone: 832-858-9764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number32157
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3021306
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number32157
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: