MEDICARE: MAYER SMILE BE BRIGHT

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1508641937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAYER SMILE BE BRIGHT

Provider Business Mailing Address
First Line	:	814 VILLA RIDGE RD
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-3663
Country	:	US
Telephone Number	:	571-366-3992
Fax Number	:	571-366-3994

Provider Business Practice Location Address
First Line	:	6500 WILLIAMSBURG BLVD
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22213-1329
Country	:	US
Telephone Number	:	571-366-3992
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	MS. EDITH MARTINEZ
Credential	:
Telephone Number	:	571-277-3592

Provider Enumeration Date	:	08/24/2023
Last Update Date	:	08/25/2023

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Directions to “MAYER SMILE BE BRIGHT ” Practice Location

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