Provider Demographics
NPI:1093708307
Name:LOBO, CHERYL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:A
Last Name:LOBO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 DALE BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-2550
Mailing Address - Country:US
Mailing Address - Phone:703-680-2070
Mailing Address - Fax:703-680-7722
Practice Address - Street 1:4421 DALE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-2550
Practice Address - Country:US
Practice Address - Phone:703-680-2070
Practice Address - Fax:703-680-7722
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014103981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice