# LOUDOUN CENTER FOR ORAL SURGERY, PLLC

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

## Provider details

- **NPI number:** 1881163699
- **Authorized official:** DR. JASON BAE DDS, MD (OWNER/ SURGEON)
- **Authorized official phone:** (703) 544-9740

## Contact information

- **Practice address:** 46161 WESTLAKE DR STE 200, STERLING, VA 20165-5871
- **Practice address phone:** (703) 544-9740
- **Practice address fax:** (703) 544-9741
- **Mailing address:** 46161 WESTLAKE DR STE 200, STERLING, VA 20165-5871
- **Mailing address phone:** (703) 544-9740
- **Mailing address fax:** (703) 544-9741

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 11/21/2018
- **Last updated:** 11/21/2018