Provider Demographics
NPI:1568548477
Name:PLETA, EVA MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:MARIE
Last Name:PLETA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:MARIE
Other - Last Name:ENCARNACION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8308 OLD COURTHOUSE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182
Mailing Address - Country:US
Mailing Address - Phone:703-893-1100
Mailing Address - Fax:703-893-4404
Practice Address - Street 1:8308 OLD COURTHOUSE RD
Practice Address - Street 2:SUITE C
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182
Practice Address - Country:US
Practice Address - Phone:703-893-1100
Practice Address - Fax:703-893-4404
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA84010076191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice