Provider Demographics
NPI:1689228330
Name:BURNS, MEREDITH L (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:L
Last Name:BURNS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25421 LIZZIO CENTER DR STE 109
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-5828
Mailing Address - Country:US
Mailing Address - Phone:703-543-9724
Mailing Address - Fax:
Practice Address - Street 1:25421 LIZZIO CENTER DR STE 109
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-5828
Practice Address - Country:US
Practice Address - Phone:703-543-9724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD169191223G0001X
VA04014169381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice