Provider Demographics
NPI:1851866800
Name:DENTAL TOWN DC
Entity Type:Organization
Organization Name:DENTAL TOWN DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHENASI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:202-798-2090
Mailing Address - Street 1:2310 N GLEBE RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3411
Mailing Address - Country:US
Mailing Address - Phone:703-261-3649
Mailing Address - Fax:
Practice Address - Street 1:1090 VERMONT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4905
Practice Address - Country:US
Practice Address - Phone:202-798-2090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty