Provider Demographics
NPI:1912565599
Name:VAUGHAN, LILIA (RDH,BSDH)
Entity Type:Individual
Prefix:MRS
First Name:LILIA
Middle Name:
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:RDH,BSDH
Other - Prefix:
Other - First Name:LILIA
Other - Middle Name:
Other - Last Name:VAUGHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDH,BSDH
Mailing Address - Street 1:9225 DOERR RD BLDG 1220
Mailing Address - Street 2:
Mailing Address - City:FT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-2204
Mailing Address - Country:US
Mailing Address - Phone:571-231-6006
Mailing Address - Fax:
Practice Address - Street 1:9225 DOERR RD BLDG 1220
Practice Address - Street 2:
Practice Address - City:FT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-2204
Practice Address - Country:US
Practice Address - Phone:571-231-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07591124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist