Provider Demographics
NPI:1699023838
Name:NOVEL SMILES
Entity Type:Organization
Organization Name:NOVEL SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:IZZAT
Authorized Official - Middle Name:
Authorized Official - Last Name:SBEIH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-338-2697
Mailing Address - Street 1:8180 GREENSBORO DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3860
Mailing Address - Country:US
Mailing Address - Phone:703-942-8882
Mailing Address - Fax:
Practice Address - Street 1:8180 GREENSBORO DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3860
Practice Address - Country:US
Practice Address - Phone:703-942-8882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty