Healthcare Provider Details

I. General information

NPI: 1013007178
Provider Name (Legal Business Name): HONG CAO-ROTHWELL DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42010 VILLAGE CENTER PLZ SUITE 120
STONE RIDGE VA
20105-3032
US

IV. Provider business mailing address

2954 GRAY ST
OAKTON VA
22124-2605
US

V. Phone/Fax

Practice location:
  • Phone: 703-327-0441
  • Fax:
Mailing address:
  • Phone: 703-220-6179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401007870
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: