Organization
SHININGSTARS PEDIATRIC DENTISTRY PC
Active
Parent organization
SHININGSTARS PEDIATRIC DENTISTRY PC
Other names
SHININGSTARS PEDIATRIC DENTISTRY VAN NESS
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHININGSTARS PEDIATRIC DENTISTRY PC
Authorized official
GINA CUC PHAM DDS (PRESIDENT)
(202) 600-4833
Entity
Organization
Contact information
Practice address
4301 CONNECTICUT AVE NW STE 453, WASHINGTON, DC 20008-2356
(202) 470-3676
Mailing address
PO BOX 10083, MC LEAN, VA 22102-8083
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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