Provider Demographics
NPI:1720193493
Name:BRITTO, AJIT DENIS (DDS, MSD,)
Entity Type:Individual
Prefix:DR
First Name:AJIT
Middle Name:DENIS
Last Name:BRITTO
Suffix:
Gender:M
Credentials:DDS, MSD,
Other - Prefix:DR
Other - First Name:DENIS
Other - Middle Name:AJIT
Other - Last Name:BRITTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MSD,
Mailing Address - Street 1:4080 LAFAYETTE CENTER DR STE 160A
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1248
Mailing Address - Country:US
Mailing Address - Phone:703-230-6784
Mailing Address - Fax:703-230-0509
Practice Address - Street 1:4080 LAFAYETTE CENTER DR STE 160A
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1248
Practice Address - Country:US
Practice Address - Phone:703-230-6784
Practice Address - Fax:703-230-0509
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010089461223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics