Individual
MISS LINI CAI MICKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
1141 ELDEN ST, HERNDON, VA 20170-5549
(703) 443-2000
Mailing address
1141 ELDEN ST, HERNDON, VA 20170-5549
(703) 443-2000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9123
AZ
1223G0001X
General Practice Dentistry
Primary
000150
AL
1223G0001X
General Practice Dentistry
0401418800
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2009
Last updated
01/08/2026
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