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General NPI Number Information
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NPI Number | 1285792614
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Entity Type | Individual
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Provider Name | FAITH VENTURA DELONG DDS
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1701 CLARENDON BLVD STE 220
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City | ARLINGTON
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State | VA
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Zip | 22209-2700
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Country | US
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Telephone | 703-528-8118
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Fax |
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Provider Business Mailing Address
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Address Line | 1018 N MADISON ST
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City | ARLINGTON
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State | VA
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Zip | 22205-1642
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Country | US
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Telephone | 703-237-4378
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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 | DD1937
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License Number State | NM
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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 | 0401414157
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License Number State | VA
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