# GD VA PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vienna Smiles, Tyson Smiles, National Landing Smiles, Westover Dentistry, Mosaic Smiles, Tyson's Dental Esthetics, Smiles Specialty Center, Lowes Island Dentistry, Fairfax Dental Esthetics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871139519
- **Authorized official:** DAVID ROWE (INTEGRATION SPECIALIST)
- **Authorized official phone:** (610) 243-2018

## Contact information

- **Practice address:** 2553 CHAIN BRIDGE RD, VIENNA, VA 22181-5517
- **Practice address phone:** (703) 938-0212
- **Mailing address:** 2553 CHAIN BRIDGE ROAD, ATTN: MICHELLE RYAN, VIENNA, VA 22181
- **Mailing address phone:** (703) 938-0212
- **Mailing address fax:** (703) 938-2166

## Taxonomy

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

## Other

- **Enumeration date:** 11/18/2019
- **Last updated:** 11/18/2019