Provider Demographics
NPI:1518359710
Name:HEBDA, ANN N (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:N
Last Name:HEBDA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20600 GORDON PARK SQ
Mailing Address - Street 2:SUITE 190
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-3145
Mailing Address - Country:US
Mailing Address - Phone:703-723-9788
Mailing Address - Fax:
Practice Address - Street 1:20600 GORDON PARK SQ
Practice Address - Street 2:SUITE 190
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3145
Practice Address - Country:US
Practice Address - Phone:703-723-9788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-24
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010087891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice