Provider Demographics
NPI:1225188527
Name:ROCA, LUPITA MARICELA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LUPITA
Middle Name:MARICELA
Last Name:ROCA
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 1:6950 FAIRFAX DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22213-1012
Mailing Address - Country:US
Mailing Address - Phone:703-237-7622
Mailing Address - Fax:703-237-7632
Practice Address - Street 1:6950 FAIRFAX DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22213-1012
Practice Address - Country:US
Practice Address - Phone:703-237-7622
Practice Address - Fax:703-237-7632
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010077791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice