Provider Demographics
NPI:1275194920
Name:FERREIRA, CAROLINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINA
Middle Name:
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9322 BRAYMORE CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039-3119
Mailing Address - Country:US
Mailing Address - Phone:703-350-3854
Mailing Address - Fax:
Practice Address - Street 1:4458 ELECTRIC RD STE C
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-0704
Practice Address - Country:US
Practice Address - Phone:540-283-5365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401417868122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist