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General NPI Number Information
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NPI Number | 1336696434
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Entity Type | Organization
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Legal Business Name | SMILE STUDIO INC.
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 09/07/2016
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Provider Practice Location Address
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Address Line | 7787 LEESBURG PIKE SUITE 200
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City | FALLS CHURCH
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State | VA
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Zip | 22043-2412
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Country | US
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Telephone | 703-982-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 7787 LEESBURG PIKE SUITE 200
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City | FALLS CHURCH
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State | VA
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Zip | 22043-2412
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Country | US
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Telephone | 703-982-2222
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | ELI JANABI
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Credential | DDS
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Telephone | 703-982-2222
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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 | 0401414930
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License Number State | VA
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