Healthcare Provider Details

I. General information

NPI: 1639098312
Provider Name (Legal Business Name): ONUR NACAKGEDIGI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8310 OLD COURTHOUSE RD STE A
TYSONS VA
22182-3872
US

IV. Provider business mailing address

3600 ELDERBERRY PL
FAIRFAX VA
22033-1214
US

V. Phone/Fax

Practice location:
  • Phone: 703-356-0250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401420154
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: