Provider Demographics
NPI:1558887224
Name:B&R ENDODONTIC ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:B&R ENDODONTIC ASSOCIATES, PLLC
Other - Org Name:NORTHERN VIRGINIA ENDODONTIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHERON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:703-528-8382
Mailing Address - Street 1:3833 FAIRFAX DR STE 440
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1773
Mailing Address - Country:US
Mailing Address - Phone:703-528-8382
Mailing Address - Fax:703-469-1708
Practice Address - Street 1:8987 HERSAND DR
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1604
Practice Address - Country:US
Practice Address - Phone:703-528-8382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty