Provider Demographics
NPI:1821193798
Name:NASR, FLAVIO W (DDS)
Entity Type:Individual
Prefix:DR
First Name:FLAVIO
Middle Name:W
Last Name:NASR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 CRYSTAL PLAZA ARC
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-4602
Mailing Address - Country:US
Mailing Address - Phone:703-415-0555
Mailing Address - Fax:703-415-0554
Practice Address - Street 1:2800 CRYSTAL DR STE 320
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-3590
Practice Address - Country:US
Practice Address - Phone:703-415-0555
Practice Address - Fax:703-415-0554
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010072171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice