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General NPI Number Information
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NPI Number | 1992654230
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Entity Type | Organization
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Legal Business Name | ULTRA SMILES LLC
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 12104 SHERATON HILLS DR
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City | FREDERICKSBRG
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State | VA
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Zip | 22407-6748
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Country | US
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Telephone | 540-443-3112
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Fax |
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Provider Business Mailing Address
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Address Line | 12104 SHERATON HILLS DR
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City | FREDERICKSBRG
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State | VA
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Zip | 22407-6748
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABEER BASRI
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Credential | DMD
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Telephone | 857-263-1503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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