Provider Demographics
NPI:1184366585
Name:SERAPHIM, VICTORIA EMILIA (DDS)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:EMILIA
Last Name:SERAPHIM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5112 DONOVAN DR APT 109
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-8685
Mailing Address - Country:US
Mailing Address - Phone:310-663-7021
Mailing Address - Fax:
Practice Address - Street 1:80 E JEFFERSON ST STE 400B
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3569
Practice Address - Country:US
Practice Address - Phone:703-241-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA04014187421223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program