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General NPI Number Information
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NPI Number | 1669049722
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Entity Type | Individual
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Provider Name | SUNNA BASHIR DDS
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Gender | Female
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 9901 FAIRFAX BLVD
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City | FAIRFAX
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State | VA
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Zip | 22030-1740
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Country | US
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Telephone | 703-348-4216
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Fax |
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Provider Business Mailing Address
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Address Line | 6307 KNOLLS POND LN
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City | FAIRFAX STATION
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State | VA
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Zip | 22039-1654
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Country | US
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Telephone | 703-463-6148
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DS043199
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0401417578
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License Number State | VA
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