Provider Demographics
NPI:1629309133
Name:BIGGS&TINGLING
Entity Type:Organization
Organization Name:BIGGS&TINGLING
Other - Org Name:DESTINATION SMILE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLAVIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:TINGLING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-358-5100
Mailing Address - Street 1:9010 LORTON STATION BLVD
Mailing Address - Street 2:UNIT 120
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4792
Mailing Address - Country:US
Mailing Address - Phone:703-339-3993
Mailing Address - Fax:
Practice Address - Street 1:9010 LORTON STATION BLVD
Practice Address - Street 2:UNIT 120
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4792
Practice Address - Country:US
Practice Address - Phone:703-339-3993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty