# JOSEPH D. MADISON, DMD, LTD.

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

## Provider details

- **NPI number:** 1659567972
- **Authorized official:** DR. JOSEPH DWAYNE MADISON D.M.D. (PRESIDENT)
- **Authorized official phone:** (703) 391-8836

## Contact information

- **Practice address:** 11800 SUNRISE VALLEY DR, SUITE 1137, RESTON, VA 20191-5300
- **Practice address phone:** (703) 391-8836
- **Practice address fax:** (703) 391-6802
- **Mailing address:** 11800 SUNRISE VALLEY DR, SUITE 1137, RESTON, VA 20191-5300
- **Mailing address phone:** (703) 391-8836
- **Mailing address fax:** (703) 391-6802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 0401006578 | VA | Yes |

## Other

- **Enumeration date:** 09/20/2007
- **Last updated:** 09/20/2007