# VIVID SMILES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vivid Smiles
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477226892
- **Authorized official:** DR. JORGE VIVONI DMD (DENTIST)
- **Authorized official phone:** (703) 333-6077

## Contact information

- **Practice address:** 7011 BACKLICK CT, SPRINGFIELD, VA 22151-3903
- **Practice address phone:** (703) 333-6077
- **Mailing address:** 7011 BACKLICK CT, SPRINGFIELD, VA 22151-3903
- **Mailing address phone:** (703) 333-6077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 07/30/2021
- **Last updated:** 07/30/2021