# MERRIFIELD DENTAL GROUP PLLC

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

## Provider details

- **NPI number:** 1790486827
- **Authorized official:** GEITH KALLAS DDS (OWNER)
- **Authorized official phone:** (703) 622-3300

## Contact information

- **Practice address:** 2810 OLD LEE HWY STE 200A, FAIRFAX, VA 22031-4376
- **Practice address phone:** (703) 945-2200
- **Mailing address:** 8310 OLD COURTHOUSE RD STE A, VIENNA, VA 22182-3872

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/15/2023
- **Last updated:** 12/18/2023