# SUSANA RAYGADA D.M.D., P.C.

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

## Provider details

- **NPI number:** 1558536672
- **Authorized official:** SUSANA RAYGADA D.M.D. (DENTIST)
- **Authorized official phone:** (703) 323-1400

## Contact information

- **Practice address:** 5211 LYNGATE CT, BURKE, VA 22015-1671
- **Practice address phone:** (703) 323-1400
- **Practice address fax:** (703) 426-0415
- **Mailing address:** 5211 LYNGATE CT, BURKE, VA 22015-1671
- **Mailing address phone:** (703) 323-1400
- **Mailing address fax:** (703) 426-0415

## Taxonomy

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

## Other

- **Enumeration date:** 04/29/2008
- **Last updated:** 04/05/2012