Provider Demographics
NPI:1033854468
Name:KWIATKOWSKI-SPIELER, JOYCE (RDH)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:
Last Name:KWIATKOWSKI-SPIELER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 WRIGHTWOOD PL
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-1129
Mailing Address - Country:US
Mailing Address - Phone:703-915-3239
Mailing Address - Fax:
Practice Address - Street 1:44115 WOODRIDGE PKWY STE 280
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-5199
Practice Address - Country:US
Practice Address - Phone:703-858-2380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402203413124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0402203413OtherDEPARTMENT OF HEALTH PROFESSIONS
0402203413OtherDEPARTMENT OFPROFESSIONS
VA0402203413OtherDEPARTMENT OF HEALTH PROFESSIOALS