Provider Demographics
NPI:1326326265
Name:CLAUSTRO, JOANNA (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:
Last Name:CLAUSTRO
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 1:21495 RIDGETOP CIR
Mailing Address - Street 2:SUITE #100
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6512
Mailing Address - Country:US
Mailing Address - Phone:703-406-8600
Mailing Address - Fax:
Practice Address - Street 1:21495 RIDGETOP CIR
Practice Address - Street 2:SUITE #100
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6512
Practice Address - Country:US
Practice Address - Phone:703-406-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2013-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1855674122300000X
VA0401413783122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist