Provider Demographics
NPI:1689022808
Name:UNITED SMILES, PC
Entity Type:Organization
Organization Name:UNITED SMILES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:P
Authorized Official - Last Name:VARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:804-706-6666
Mailing Address - Street 1:12712 JEFFERSON DAVIS HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-5369
Mailing Address - Country:US
Mailing Address - Phone:804-706-6666
Mailing Address - Fax:804-454-0391
Practice Address - Street 1:12712 JEFFERSON DAVIS HWY
Practice Address - Street 2:SUITE A
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-5369
Practice Address - Country:US
Practice Address - Phone:804-706-6666
Practice Address - Fax:804-454-0391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4014110751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA207228Medicaid