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NPI Code Detail

MEDICARE: VIVINE DENTAL STUDIO

MEDICARE: VIVINE DENTAL STUDIO
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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1871445114
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIVINE DENTAL STUDIO
Provider Business Mailing Address
First Line : 13210 FOX RIPPLE LN
Second Line :
City : HERNDON
State : VA
Zip : 20171-3042
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 915 N QUINCY ST
Second Line :
City : ARLINGTON
State : VA
Zip : 22203-1907
Country : US
Telephone Number : 703-276-1010
Fax Number :
Authorized Official
Title or Position : OWNER DENTIST
Name : DR. VINEETHA VIJAYAKUMAR
Credential : DMD
Telephone Number : 572-373-9906
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

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Directions to “VIVINE DENTAL STUDIO ” Practice Location

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