MEDICARE: DILEEP THOMAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	0401419504	VA

General Provider Information

NPI Number	:	1144070947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DILEEP THOMAS

Provider Business Mailing Address
First Line	:	13084 AUTUMN WILLOW DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-8202
Country	:	US
Telephone Number	:	571-591-9828
Fax Number	:

Provider Business Practice Location Address
First Line	:	475 GREEN ROCK LN
Second Line	:
City	:	CHATHAM
State	:	VA
Zip	:	24531-5410
Country	:	US
Telephone Number	:	434-797-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2024
Last Update Date	:	12/23/2025

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Directions to “ DILEEP THOMAS ” Practice Location

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