Provider Demographics
NPI:1265702427
Name:GOLIAN, TIMOTHY (DDS)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:
Last Name:GOLIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 CHAIN BRIDGE RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-3937
Mailing Address - Country:US
Mailing Address - Phone:703-273-8798
Mailing Address - Fax:703-273-4212
Practice Address - Street 1:3925 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE 304
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3937
Practice Address - Country:US
Practice Address - Phone:703-273-8798
Practice Address - Fax:703-273-4212
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010078871223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics