Healthcare Provider Details

I. General information

NPI: 1902634645
Provider Name (Legal Business Name): HELENA KILIC, DMD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2968 CHAIN BRIDGE RD STE B
OAKTON VA
22124-3038
US

IV. Provider business mailing address

2968 CHAIN BRIDGE RD STE B
OAKTON VA
22124-3038
US

V. Phone/Fax

Practice location:
  • Phone: 703-938-1900
  • Fax: 703-938-4040
Mailing address:
  • Phone: 703-938-1900
  • Fax: 703-938-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. HELENA KILIC
Title or Position: ORTHODONTIST
Credential: DMD
Phone: 310-845-5760