Provider Demographics
NPI:1366452500
Name:GEORGE-JOB, ANITA G (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:G
Last Name:GEORGE-JOB
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 1:2870 JERMANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-2513
Mailing Address - Country:US
Mailing Address - Phone:703-281-2513
Mailing Address - Fax:
Practice Address - Street 1:5827 COLUMBIA PIKE
Practice Address - Street 2:#405
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-2027
Practice Address - Country:US
Practice Address - Phone:703-820-7189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014108021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice