Provider Demographics
NPI:1073304358
Name:PLAYTIME PEDIATRIC DENTISTRY AND ORTHODONTICS,PLLC
Entity type:Organization
Organization Name:PLAYTIME PEDIATRIC DENTISTRY AND ORTHODONTICS,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SASHA
Authorized Official - Middle Name:LOVETTE
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-601-3932
Mailing Address - Street 1:14573 POTOMAC MILLS RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-6808
Mailing Address - Country:US
Mailing Address - Phone:703-499-9779
Mailing Address - Fax:703-499-9774
Practice Address - Street 1:1130 STAFFORD MARKET PL # 101
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-4524
Practice Address - Country:US
Practice Address - Phone:571-200-0663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty