Provider Demographics
NPI:1083807150
Name:PHASS, DEAN J (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:J
Last Name:PHASS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 LEESBURG PIKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-3802
Mailing Address - Country:US
Mailing Address - Phone:703-824-0055
Mailing Address - Fax:703-998-9859
Practice Address - Street 1:5205 LEESBURG PIKE
Practice Address - Street 2:SUITE 101
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-3802
Practice Address - Country:US
Practice Address - Phone:703-824-0055
Practice Address - Fax:703-998-9859
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice