Provider Demographics
NPI:1033630041
Name:PRECISION ORTHODONTICS, PC
Entity Type:Organization
Organization Name:PRECISION ORTHODONTICS, PC
Other - Org Name:ORTHODONTIC PRECISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOAI-LAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-391-8800
Mailing Address - Street 1:12359 SUNRISE VALLEY DR STE 210
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3493
Mailing Address - Country:US
Mailing Address - Phone:703-391-8800
Mailing Address - Fax:703-391-8801
Practice Address - Street 1:12359 SUNRISE VALLEY DR STE 210
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3493
Practice Address - Country:US
Practice Address - Phone:703-391-8800
Practice Address - Fax:703-391-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014129591223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1144533415OtherOWNER