# HERNDON WALKING SMILES

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

## Provider details

- **NPI number:** 1992110811
- **Authorized official:** MALIK M USMAN DDS (DENTIST)
- **Authorized official phone:** (240) 505-2012

## Contact information

- **Practice address:** 201 ELDEN ST STE 102, HERNDON, VA 20170-4812
- **Practice address phone:** (703) 437-6366
- **Practice address fax:** (703) 435-8485
- **Mailing address:** 201 ELDEN ST STE 102, HERNDON, VA 20170-4812
- **Mailing address phone:** (703) 437-6366
- **Mailing address fax:** (703) 435-8485

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401413042 | VA | Yes |

## Other

- **Enumeration date:** 06/30/2014
- **Last updated:** 06/30/2014