Provider Demographics
NPI:1518395367
Name:RODNEY J. KLIMA, DDS, PC
Entity Type:Organization
Organization Name:RODNEY J. KLIMA, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KLIMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-425-5125
Mailing Address - Street 1:5204B LYNGATE CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1631
Mailing Address - Country:US
Mailing Address - Phone:703-425-5125
Mailing Address - Fax:703-425-6281
Practice Address - Street 1:5204B LYNGATE CT
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1631
Practice Address - Country:US
Practice Address - Phone:703-425-5125
Practice Address - Fax:703-425-6281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010046601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9178575Medicaid