Provider Demographics
NPI:1497096069
Name:CALKINS, LILIANA
Entity Type:Individual
Prefix:DR
First Name:LILIANA
Middle Name:
Last Name:CALKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LILIANA
Other - Middle Name:
Other - Last Name:CALKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:504 SCENIC WAY
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-3012
Mailing Address - Country:US
Mailing Address - Phone:571-244-7329
Mailing Address - Fax:703-476-3967
Practice Address - Street 1:11490 COMMERCE PARK DR
Practice Address - Street 2:430
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1557
Practice Address - Country:US
Practice Address - Phone:703-476-3969
Practice Address - Fax:703-476-3967
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014132951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics