Provider Demographics
NPI:1043620263
Name:SCOTT, TAMASHA TRIPLETT (DDS)
Entity Type:Individual
Prefix:
First Name:TAMASHA
Middle Name:TRIPLETT
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:TAMASHA
Other - Middle Name:N
Other - Last Name:TRIPLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:11670 SUDLEY MANOR DR
Mailing Address - Street 2:SUITE 290
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-2842
Mailing Address - Country:US
Mailing Address - Phone:571-359-6424
Mailing Address - Fax:571-359-6579
Practice Address - Street 1:11670 SUDLEY MANOR DR
Practice Address - Street 2:SUITE 290
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2842
Practice Address - Country:US
Practice Address - Phone:571-359-6424
Practice Address - Fax:571-359-6579
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014143911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice