Organization
DULLES DENTAL CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FIROUZEH ABBASSI (OFFICE MANAGER)
(703) 471-8080
Entity
Organization
Contact information
Practice address
1035 STERLING RD, SUITE 204, HERNDON, VA 20170-3868
(703) 471-8080
(703) 471-5354
Mailing address
1035 STERLING RD, SUITE 204, HERNDON, VA 20170-3838
(703) 471-8080
(703) 471-5354
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401007323
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069063
ANTHEM-TRIGON
—
01
—
2155650
MAMSI
—
01
—
2407323
DELTA DENTAL-NEW JERSEY
NJ
01
—
412173
BCBS-TENNESSEE
TN
01
—
602999
UNITED CONCORDIA
—
01
—
8724
BCBS-MARYLAND
MD
01
—
923-87911
BCBS-ALABAMA
AL
01
—
Z81548
BCBS-MASSACHUSETTS
MA
Enumeration date
05/04/2007
Last updated
01/08/2009
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