Healthcare Provider Details

I. General information

NPI: 1932445533
Provider Name (Legal Business Name): ADAMS SMILE CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2012
Last Update Date: 12/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46161 WESTLAKE DR SUITE 220
STERLING VA
20165-5871
US

IV. Provider business mailing address

46161 WESTLAKE DR SUITE 220
STERLING VA
20165-5871
US

V. Phone/Fax

Practice location:
  • Phone: 703-430-1212
  • Fax:
Mailing address:
  • Phone: 703-430-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateVA

VIII. Authorized Official

Name: MAQSOOD A CHAUDHRY
Title or Position: OWNER
Credential: DDS
Phone: 703-430-1212