=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629309133
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BIGGS&TINGLING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2010
-----------------------------------------------------
Last Update Date | 01/22/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9010 LORTON STATION BLVD UNIT 120
-----------------------------------------------------
City | LORTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22079-4792
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-339-3993
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9010 LORTON STATION BLVD UNIT 120
-----------------------------------------------------
City | LORTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22079-4792
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-339-3993
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. FLAVIA D TINGLING
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 734-358-5100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------