Provider Demographics
NPI:1891813648
Name:TSAKNIS DENTAL & ASSOCIATES
Entity Type:Organization
Organization Name:TSAKNIS DENTAL & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:TSAKNIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-724-4470
Mailing Address - Street 1:20600 GORDON PARK SQ
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-3145
Mailing Address - Country:US
Mailing Address - Phone:703-724-4470
Mailing Address - Fax:703-724-0432
Practice Address - Street 1:20600 GORDON PARK SQ
Practice Address - Street 2:SUITE 110
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3145
Practice Address - Country:US
Practice Address - Phone:703-724-4470
Practice Address - Fax:703-724-0432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014102211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty