Provider Demographics
NPI:1598058281
Name:CNS DENTAL
Entity Type:Organization
Organization Name:CNS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:202-285-9406
Mailing Address - Street 1:3650 S GLEBE RD STE 195
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-5606
Mailing Address - Country:US
Mailing Address - Phone:703-963-0996
Mailing Address - Fax:
Practice Address - Street 1:3650 S. GLEBE RD. #195
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202
Practice Address - Country:US
Practice Address - Phone:703-963-0996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA041411557305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization