Provider Demographics
NPI:1427360023
Name:GOLDIN, ANDREA F (DMD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:F
Last Name:GOLDIN
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 1:9010 LORTON STATION BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4792
Mailing Address - Country:US
Mailing Address - Phone:703-337-4272
Mailing Address - Fax:
Practice Address - Street 1:9010 LORTON STATION BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4792
Practice Address - Country:US
Practice Address - Phone:703-337-4272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401431091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice