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General NPI Number Information
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NPI Number | 1467055152
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Entity Type | Organization
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Legal Business Name | CHILDRENS CARDIAC CARE LLC
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 02/22/2026
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Provider Practice Location Address
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Address Line | 609 EMANCIPATION HWY STE 201
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4566
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Country | US
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Telephone | 540-322-4949
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Fax | 571-376-6553
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Provider Business Mailing Address
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Address Line | 609 EMANCIPATION HWY STE 201
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4566
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Country | US
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Telephone | 540-322-4949
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Fax | 571-376-6553
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | DR. AMIR DANGOL
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Credential |
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Telephone | 571-364-2301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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