=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164381828
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LINDABWANSI PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2026
-----------------------------------------------------
Last Update Date | 01/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 950 HERNDON PKWY
-----------------------------------------------------
City | HERNDON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20170-5531
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-347-1508
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1693 WINTERWOOD CT
-----------------------------------------------------
City | HERNDON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20170-2990
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-347-1508
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PEDIATRIC DENTIST
-----------------------------------------------------
Name | DR. LINDA WANSI
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 703-347-1508
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------