Provider Demographics
NPI:1740793355
Name:AMY TON DDS PLLC
Entity Type:Organization
Organization Name:AMY TON DDS PLLC
Other - Org Name:SUNRISE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:TON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-943-8686
Mailing Address - Street 1:11868 SUNRISE VALLEY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3320
Mailing Address - Country:US
Mailing Address - Phone:703-860-6700
Mailing Address - Fax:703-860-6657
Practice Address - Street 1:11868 SUNRISE VALLEY DR STE 100
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3320
Practice Address - Country:US
Practice Address - Phone:703-860-6700
Practice Address - Fax:703-860-6657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014141711223G0001X
VA04014141611223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty