Provider Demographics
NPI:1487672127
Name:LAM & BOCAGE ORTHODONTICS, PLLC
Entity Type:Organization
Organization Name:LAM & BOCAGE ORTHODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:LAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MMSC
Authorized Official - Phone:703-522-5513
Mailing Address - Street 1:450 N THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-2480
Mailing Address - Country:US
Mailing Address - Phone:703-522-5513
Mailing Address - Fax:
Practice Address - Street 1:450 N THOMAS ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-2480
Practice Address - Country:US
Practice Address - Phone:703-522-5513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014111491223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty