# LUMEN DENTAL OF TYSONS CORNER LLC

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

## Provider details

- **NPI number:** 1720949191
- **Authorized official:** NIMA RAOUFINIA DDS (MEMBER)
- **Authorized official phone:** (703) 219-8575

## Contact information

- **Practice address:** 8300 GREENSBORO DR, ST 160A, MC LEAN, VA 22102-3605
- **Practice address phone:** (703) 219-8575
- **Mailing address:** 8300 GREENSBORO DR, MC LEAN, VA 22102-3605
- **Mailing address phone:** (703) 219-8575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/24/2025
- **Last updated:** 11/24/2025