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General NPI Number Information
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NPI Number | 1477759298
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Entity Type | Individual
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Provider Name | NEAL D. KRAVITZ DMD, MS
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Gender | Male
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 25055 RIDING PLAZA SUITE 110
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City | CHANTILLY
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State | VA
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Zip | 20152-5918
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Country | US
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Telephone | 703-722-2900
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Fax | 703-722-2903
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Provider Business Mailing Address
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Address Line | 25055 RIDING PLAZA SUITE 110
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City | CHANTILLY
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State | VA
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Zip | 20152-5918
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Country | US
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Telephone | 703-722-2900
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Fax | 703-722-2903
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 13716
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License Number State | MD
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