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General NPI Number Information
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NPI Number | 1841000239
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Entity Type | Organization
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Legal Business Name | SPRINGFIELD ENDODONTICS
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 7426 ALBAN STATION BLVD STE B202
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City | SPRINGFIELD
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State | VA
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Zip | 22150-2323
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Country | US
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Telephone | 317-989-9730
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Fax |
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Provider Business Mailing Address
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Address Line | 43145 VALIANT DR
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City | CHANTILLY
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State | VA
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Zip | 20152-3423
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Country | US
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Telephone | 317-989-9730
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANMAR AL-JANABI
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Credential | DDS, MSD, MSC
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Telephone | 571-303-0313
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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 |
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License Number State |
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