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General NPI Number Information
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NPI Number | 1013342161
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Entity Type | Organization
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Legal Business Name | VIRGINIA SMILES PLLC
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Dates
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Enumeration Date | 09/09/2013
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 21001 SYCOLIN RD STE 100
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City | ASHBURN
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State | VA
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Zip | 20147-4074
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Country | US
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Telephone | 571-291-9699
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Fax |
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Provider Business Mailing Address
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Address Line | 21001 SYCOLIN RD STE 100
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City | ASHBURN
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State | VA
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Zip | 20147-4074
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Country | US
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Telephone | 571-291-9699
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WASIM QURESHI
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Credential | DDS
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Telephone | 571-291-9699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401413931
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License Number State | VA
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