Provider Demographics
NPI:1700191251
Name:GUO, JUANLI (DMD, MS, PHD, FACP)
Entity Type:Individual
Prefix:DR
First Name:JUANLI
Middle Name:
Last Name:GUO
Suffix:
Gender:F
Credentials:DMD, MS, PHD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8321 OLD COURTHOUSE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3817
Mailing Address - Country:US
Mailing Address - Phone:703-992-0674
Mailing Address - Fax:703-992-0714
Practice Address - Street 1:8321 OLD COURTHOUSE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3817
Practice Address - Country:US
Practice Address - Phone:703-992-0674
Practice Address - Fax:703-992-0714
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2012-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014126011223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics