Provider Demographics
NPI:1376420505
Name:DR NILI DENTAL CARE LLC
Entity type:Organization
Organization Name:DR NILI DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NILIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUNWAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-522-3363
Mailing Address - Street 1:1635 N GEORGE MASON DR STE 160
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3680
Mailing Address - Country:US
Mailing Address - Phone:703-522-3363
Mailing Address - Fax:703-522-3370
Practice Address - Street 1:1635 N GEORGE MASON DR STE 160
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3680
Practice Address - Country:US
Practice Address - Phone:703-522-3363
Practice Address - Fax:703-522-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty