Healthcare Provider Details

I. General information

NPI: 1538456629
Provider Name (Legal Business Name): ANETA ANNA RACZYNSKA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2011
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10051 MARKET CIR
MANASSAS VA
20110-2120
US

IV. Provider business mailing address

10051 MARKET CIR
MANASSAS VA
20110-2120
US

V. Phone/Fax

Practice location:
  • Phone: 240-462-7864
  • Fax: 571-421-1366
Mailing address:
  • Phone: 240-462-7864
  • Fax: 571-421-1366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401413207
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: