Provider Demographics
NPI:1548564297
Name:ARLINGTON ENDODONTICS, PLLC
Entity Type:Organization
Organization Name:ARLINGTON ENDODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAWANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FEIMSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:571-312-3762
Mailing Address - Street 1:4350 N. FAIRFAX DR.
Mailing Address - Street 2:SUITE 160
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1695
Mailing Address - Country:US
Mailing Address - Phone:571-312-3762
Mailing Address - Fax:
Practice Address - Street 1:4350 NORTHFAIRFAX DRIVE
Practice Address - Street 2:SUITE 160
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1695
Practice Address - Country:US
Practice Address - Phone:571-312-3762
Practice Address - Fax:571-312-3592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014128571223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty