# SANAE BOUALLALI BERRADA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tysons Dental Esthetics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689009961
- **Authorized official:** SANAE BERRADA DDS (OWNER)
- **Authorized official phone:** (703) 821-8111

## Contact information

- **Practice address:** 7641 LEESBURG PIKE, FALLS CHURCH, VA 22043-2520
- **Practice address phone:** (703) 821-8111
- **Practice address fax:** (703) 821-1512
- **Mailing address:** 7641 LEESBURG PIKE, FALLS CHURCH, VA 22043-2520
- **Mailing address phone:** (703) 821-8111
- **Mailing address fax:** (703) 821-1512

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401411776 | VA | Yes |

## Other

- **Enumeration date:** 09/05/2013
- **Last updated:** 09/05/2013