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General NPI Number Information
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NPI Number | 1417886540
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Entity Type | Individual
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Provider Name | MRS. SAIRA ELISABETH GARDNER
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Gender | Female
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 05/15/2026
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Provider Practice Location Address
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Address Line | 401 CARPENTER RD FL 2
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City | FORT MYER
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State | VA
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Zip | 22211-1009
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Country | US
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Telephone | 703-696-3460
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Fax |
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Provider Business Mailing Address
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Address Line | 43445 LIVERY SQ
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City | ASHBURN
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State | VA
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Zip | 20147-5341
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Country | US
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Telephone | 832-293-3929
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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 | 126800000X
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Taxonomy Name | Dental Assistant
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License Number | 91092
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License Number State | TX
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