# NOVA CHILDREN'S GENERAL ANESTHESIA DENTISTRY, PLLC

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

## Provider details

- **NPI number:** 1447031380
- **Authorized official:** JEFFREY WHEELER (CEO)
- **Authorized official phone:** (301) 494-3000

## Contact information

- **Practice address:** 8505 ARLINGTON BLVD STE 100, FAIRFAX, VA 22031-4630
- **Practice address phone:** (703) 705-2277
- **Mailing address:** 1220 CARAWAY CT STE 1050, UPPER MARLBORO, MD 20774-5338
- **Mailing address phone:** (301) 494-3000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |
| 1223D0004X | Dental Anesthesiology | — | NULL | — |
| 1223D0004X | Dental Anesthesiology | — | — | — |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | NULL | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LP3000X | Pediatric Anesthesiology Physician | — | NULL | — |
| 207LP3000X | Pediatric Anesthesiology Physician | — | — | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 10/06/2023
- **Last updated:** 08/17/2026