Provider Demographics
NPI:1427405471
Name:TOP NOVA ORTHODONTICS, PLLC
Entity Type:Organization
Organization Name:TOP NOVA ORTHODONTICS, PLLC
Other - Org Name:TOP NOVA ORTHODONTICS, PLLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AZITA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBASI-HAFSHEJANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-444-9373
Mailing Address - Street 1:46165 WESTLAKE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5872
Mailing Address - Country:US
Mailing Address - Phone:703-444-9373
Mailing Address - Fax:703-444-9240
Practice Address - Street 1:46165 WESTLAKE DR STE 300
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5872
Practice Address - Country:US
Practice Address - Phone:703-444-9373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA04014138451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty