# NOVA DENTAL

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

## Provider details

- **NPI number:** 1366794026
- **Authorized official:** DR. RICHARD SUN DDS (PRESIDENT)
- **Authorized official phone:** (571) 313-1535

## Contact information

- **Practice address:** 11872 SUNRISE VALLEY DR, SUITE 101, RESTON, VA 20191-3321
- **Practice address phone:** (571) 313-1535
- **Mailing address:** 11872 SUNRISE VALLEY DR, SUITE 101, RESTON, VA 20191-3321

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401411269 | VA | Yes |

## Other

- **Enumeration date:** 10/04/2012
- **Last updated:** 10/04/2012