# AESTHETIC DENTISTRY OF LORTON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dr. Reeves
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528396330
- **Authorized official:** VALERIE BECKER (OFFICE MANAGER)
- **Authorized official phone:** (703) 339-5090

## Contact information

- **Practice address:** 7764 ARMISTEAD ROAD, SUITE 100, LORTON, VA 22079-1918
- **Practice address phone:** (703) 339-5090
- **Practice address fax:** (703) 339-1068
- **Mailing address:** 7764 ARMISTEAD ROAD, SUITE 100, LORTON, VA 22079-1918
- **Mailing address phone:** (703) 339-5090
- **Mailing address fax:** (703) 339-1068

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 0401410574 | VA | — |
| 1223G0001X | General Practice Dentistry | 0401411477 | VA | Yes |
| 1223G0001X | General Practice Dentistry | 4477 | VA | — |
| 1223G0001X | General Practice Dentistry | 5997 | VA | — |
| 124Q00000X | Dental Hygienist | 0402002410 | VA | — |
| 124Q00000X | Dental Hygienist | 0402203732 | VA | — |

## Other

- **Enumeration date:** 12/07/2009
- **Last updated:** 07/05/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1902221 | UCCI | VA |