Provider Demographics
NPI:1962827782
Name:DONTI DENTAL, PLLC
Entity Type:Organization
Organization Name:DONTI DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:DUCHATELLIER-CANGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-723-0400
Mailing Address - Street 1:22621 AMENDOLA TER
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-7528
Mailing Address - Country:US
Mailing Address - Phone:703-723-0400
Mailing Address - Fax:703-723-0403
Practice Address - Street 1:22621 AMENDOLA TER
Practice Address - Street 2:SUITE 110
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-7528
Practice Address - Country:US
Practice Address - Phone:703-723-0400
Practice Address - Fax:703-723-0403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412622122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty