Provider Demographics
NPI:1174821003
Name:STEVE J LAN DDS PC
Entity Type:Organization
Organization Name:STEVE J LAN DDS PC
Other - Org Name:LOUDOUN PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-771-0007
Mailing Address - Street 1:1503 DODONA TER STE 200
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-4718
Mailing Address - Country:US
Mailing Address - Phone:703-771-0007
Mailing Address - Fax:703-771-6088
Practice Address - Street 1:1503 DODONA TER STE 200
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-4718
Practice Address - Country:US
Practice Address - Phone:703-771-0007
Practice Address - Fax:703-771-6088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-01
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA035518600Medicaid