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General NPI Number Information
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NPI Number | 1679416861
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Entity Type | Organization
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Legal Business Name | SIGNATURE SMILES ESTHETIC & IMPLANT DENTISTRY PLLC
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Dates
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Enumeration Date | 04/13/2026
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Last Update Date | 04/13/2026
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Provider Practice Location Address
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Address Line | 46090 LAKE CENTER PLZ STE 105
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City | STERLING
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State | VA
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Zip | 20165-5877
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Country | US
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Telephone | 202-378-0062
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Fax |
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Provider Business Mailing Address
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Address Line | 419 NIKKI TER SE
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City | LEESBURG
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State | VA
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Zip | 20175-8961
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Country | US
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Telephone | 202-378-0062
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Fax |
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Authorized Official
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Title or Position | OWNER / DENTIST
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Name | DR. LEELA DEVI SIVARAJ
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Credential | DMD
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Telephone | 202-378-0062
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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 |
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License Number State |
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