Provider Demographics
NPI:1811020167
Name:JAMES T. PLANICKA, DDS, PC
Entity Type:Organization
Organization Name:JAMES T. PLANICKA, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:PLANICKA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-734-0515
Mailing Address - Street 1:8200 GREENSBORO DR
Mailing Address - Street 2:SUITE 1002
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3892
Mailing Address - Country:US
Mailing Address - Phone:703-734-0515
Mailing Address - Fax:
Practice Address - Street 1:8200 GREENSBORO DR
Practice Address - Street 2:SUITE 1002
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3892
Practice Address - Country:US
Practice Address - Phone:703-734-0515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010049191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty