Provider Demographics
NPI:1073070819
Name:SMILE RESTON HEIGHTS
Entity Type:Organization
Organization Name:SMILE RESTON HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UPPASNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-832-4740
Mailing Address - Street 1:11800 SUNRISE VALLEY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-5300
Mailing Address - Country:US
Mailing Address - Phone:703-832-4740
Mailing Address - Fax:
Practice Address - Street 1:11800 SUNRISE VALLEY DR STE 200
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-5300
Practice Address - Country:US
Practice Address - Phone:703-832-4740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental