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General NPI Number Information
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NPI Number | 1265177463
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Entity Type | Individual
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Provider Name | ANDREA OLIVIA PAJARILLO DDS
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Gender | Female
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 450 GARRISONVILLE RD STE 201
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City | STAFFORD
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State | VA
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Zip | 22554-1615
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Country | US
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Telephone | 540-720-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 12276 DAPPLE GRAY CT
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City | WOODBRIDGE
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State | VA
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Zip | 22192-6213
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Country | US
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Telephone | 817-948-7324
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401418332
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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 | 0401418332
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License Number State | VA
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