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General NPI Number Information
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NPI Number | 1639405558
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Entity Type | Organization
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Legal Business Name | ACKERMAN & ASSOCIATES OF ALEXANDRIA, DDS, LLC
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 5055 SEMINARY RD SUITE 105
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City | ALEXANDRIA
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State | VA
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Zip | 22311-2034
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Country | US
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Telephone | 703-931-0200
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Fax | 703-931-0209
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Provider Business Mailing Address
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Address Line | 5055 SEMINARY RD SUITE 105
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City | ALEXANDRIA
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State | VA
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Zip | 22311-2034
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Country | US
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Telephone | 703-931-0200
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Fax | 703-931-0209
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Authorized Official
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Title or Position | OWNER/ DENTIST
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Name | DR. JEFFERY S ACKERMAN
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Credential |
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Telephone | 703-931-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401007743
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 401004044
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License Number State | VA
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