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General NPI Number Information
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NPI Number | 1164777173
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Entity Type | Individual
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Provider Name | CHRISTINA SAMRA DDS
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Gender | Female
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 2936 CHAIN BRIDGE RD SUITE 200
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City | OAKTON
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State | VA
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Zip | 22124-3003
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Country | US
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Telephone | 703-255-1150
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 LANDON HILL RD
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City | VIENNA
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State | VA
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Zip | 22182-1853
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0401413652
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15070
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License Number State | MD
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