Provider Demographics
NPI:1386638229
Name:WALSH, EUGENIA AUKHERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:EUGENIA
Middle Name:AUKHERT
Last Name:WALSH
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 1:9010 LORTON STATION BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4792
Mailing Address - Country:US
Mailing Address - Phone:703-339-5690
Mailing Address - Fax:703-339-5692
Practice Address - Street 1:9010 LORTON STATION BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4792
Practice Address - Country:US
Practice Address - Phone:703-339-5690
Practice Address - Fax:703-339-5692
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2015-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014121091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice