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General NPI Number Information
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NPI Number | 1598115883
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Entity Type | Individual
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Provider Name | STEPHANIE CHERI WU D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/16/2016
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Last Update Date | 07/07/2018
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Provider Practice Location Address
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Address Line | 1313 DOLLEY MADISON BLVD STE 307
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City | MC LEAN
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State | VA
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Zip | 22101
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Country | US
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Telephone | 703-847-0989
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Fax | 703-847-2681
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Provider Business Mailing Address
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Address Line | 8040 CRIANZA PL APT 355
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City | VIENNA
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State | VA
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Zip | 22182-4061
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Country | US
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Telephone | 201-956-8762
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 0401415947
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License Number State | VA
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