Provider Demographics
NPI:1508050816
Name:FARIELLO, ARNOLD S (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:S
Last Name:FARIELLO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10875 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4732
Mailing Address - Country:US
Mailing Address - Phone:703-591-4010
Mailing Address - Fax:703-591-3672
Practice Address - Street 1:10875 MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4732
Practice Address - Country:US
Practice Address - Phone:703-591-4010
Practice Address - Fax:703-591-3672
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3718122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist