Provider Demographics
NPI:1598174542
Name:BRIM, REBECCA HARPER (DMD, MS, FACP)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:HARPER
Last Name:BRIM
Suffix:
Gender:F
Credentials:DMD, MS, FACP
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:LOUISE
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1913 WOODFORD RD
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3729
Mailing Address - Country:US
Mailing Address - Phone:864-350-0955
Mailing Address - Fax:
Practice Address - Street 1:9225 DOERR RD BLDG 1220
Practice Address - Street 2:
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-2204
Practice Address - Country:US
Practice Address - Phone:864-350-0955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC83851223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics