Provider Demographics
NPI:1033635743
Name:FORGETTA, CAITLIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:
Last Name:FORGETTA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:MASSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:2833 11TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-2889
Mailing Address - Country:US
Mailing Address - Phone:516-509-3314
Mailing Address - Fax:
Practice Address - Street 1:14535 JOHN MARSHALL HWY STE 209
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-4025
Practice Address - Country:US
Practice Address - Phone:703-753-2252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2019-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101467122300000X
VA0401416235122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist