Provider Demographics
NPI:1194194407
Name:DR.ANA FRAGA
Entity Type:Organization
Organization Name:DR.ANA FRAGA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST, ORTHODONTISAT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:FRAGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:703-356-7585
Mailing Address - Street 1:2011 SOUTH GLEBE ROAD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204
Mailing Address - Country:US
Mailing Address - Phone:703-929-5023
Mailing Address - Fax:
Practice Address - Street 1:2011 S GLEBE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5308
Practice Address - Country:US
Practice Address - Phone:703-929-5023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401005878122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty