Provider Demographics
NPI:1376969386
Name:LITTLE SMILES OF NORTHERN VIRGINIA PLLC
Entity Type:Organization
Organization Name:LITTLE SMILES OF NORTHERN VIRGINIA PLLC
Other - Org Name:GROWING SMILES OF NORTHERN VIRGINIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIRTHA
Authorized Official - Middle Name:GIANNINA
Authorized Official - Last Name:GALLIANI ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-456-4584
Mailing Address - Street 1:810 N DANIEL ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-1944
Mailing Address - Country:US
Mailing Address - Phone:410-456-4584
Mailing Address - Fax:
Practice Address - Street 1:80 E. JEFFERSON ST
Practice Address - Street 2:400B
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046
Practice Address - Country:US
Practice Address - Phone:703-241-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412064261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental