Provider Demographics
NPI:1922211242
Name:SAPPERSTEIN, EVAN
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:
Last Name:SAPPERSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LITTLE FALLS ST
Mailing Address - Street 2:SUITE 201B
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4302
Mailing Address - Country:US
Mailing Address - Phone:703-534-1222
Mailing Address - Fax:
Practice Address - Street 1:200 LITTLE FALLS ST
Practice Address - Street 2:SUITE 201B
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4302
Practice Address - Country:US
Practice Address - Phone:703-534-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410064122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist