# COSMETIC AND FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093881815
- **Authorized official:** DR. NAZILA GANJI D.D.S. (PRESIDENT)
- **Authorized official phone:** (703) 793-3030

## Contact information

- **Practice address:** 13515 DULLES TECHNOLOGY DR, HERNDON, VA 20171-3413
- **Practice address phone:** (703) 793-3030
- **Practice address fax:** (703) 793-3022
- **Mailing address:** 13515 DULLES TECHNOLOGY DR, HERNDON, VA 20171-3413
- **Mailing address phone:** (703) 793-3030
- **Mailing address fax:** (703) 793-3022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401008823 | VA | Yes |

## Other

- **Enumeration date:** 11/24/2006
- **Last updated:** 08/22/2020