Provider Demographics
NPI:1558761551
Name:DENTAL DEVOTION PLLC
Entity Type:Organization
Organization Name:DENTAL DEVOTION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIR
Authorized Official - Middle Name:P
Authorized Official - Last Name:URTEAAGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-623-5702
Mailing Address - Street 1:1005 N GLEBE RD
Mailing Address - Street 2:SUITE 460
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-5718
Mailing Address - Country:US
Mailing Address - Phone:703-623-5702
Mailing Address - Fax:
Practice Address - Street 1:1005 N GLEBE RD
Practice Address - Street 2:SUITE 460
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-5718
Practice Address - Country:US
Practice Address - Phone:703-623-5702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412624261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental