MEDICARE: AMY TON DDS PLLC

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	1223P0300X	Periodontics	0401414161	VA
2	1223G0001X	General Practice Dentistry	0401414171	VA

General Provider Information

NPI Number	:	1740793355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMY TON DDS PLLC

Provider Business Mailing Address
First Line	:	11868 SUNRISE VALLEY DR STE 100
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-3320
Country	:	US
Telephone Number	:	703-860-6700
Fax Number	:	703-860-6657

Provider Business Practice Location Address
First Line	:	11868 SUNRISE VALLEY DR STE 100
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-3320
Country	:	US
Telephone Number	:	703-860-6700
Fax Number	:	703-860-6657

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AMY TON
Credential	:	DDS
Telephone Number	:	703-943-8686

Provider Enumeration Date	:	11/06/2017
Last Update Date	:	11/06/2017

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