Provider Demographics
NPI:1508252313
Name:ALINE DENTAL ASSOCIATES PC
Entity Type:Organization
Organization Name:ALINE DENTAL ASSOCIATES PC
Other - Org Name:WOODBRIDGE SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SINDHURA
Authorized Official - Middle Name:
Authorized Official - Last Name:UPPALAPATI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-999-0318
Mailing Address - Street 1:11622 VERNA DR
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-2045
Mailing Address - Country:US
Mailing Address - Phone:301-520-0405
Mailing Address - Fax:
Practice Address - Street 1:14904 JEFFERSON DAVIS HWY
Practice Address - Street 2:SUITE 304
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3908
Practice Address - Country:US
Practice Address - Phone:703-910-4805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-08
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014137271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty