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Organization

PEARSON PEDIATRIC DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TARASHA PEARSON DDS (MANAGING MEMBER)
(202) 889-5200
Entity
Organization

Contact information

Practice address
2041 MARTIN LUTHER KING JR AVE SE STE M11, WASHINGTON, DC 20020-7000
(202) 889-5200
(202) 889-5731
Mailing address
14709 PARSON WEEMS LOOP, WOODBRIDGE, VA 22193-3261
(703) 583-1635

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
074575400
DC
Enumeration date
10/10/2018
Last updated
10/10/2018
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