Healthcare Provider Details

I. General information

NPI: 1568340610
Provider Name (Legal Business Name): JESSICA HO DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6116 ROLLING RD STE 201
SPRINGFIELD VA
22152-1512
US

IV. Provider business mailing address

2410 FAIRLAND RD
SILVER SPRING MD
20904-5434
US

V. Phone/Fax

Practice location:
  • Phone: 703-451-4666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number0401419557
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: