Provider Demographics
NPI:1295741411
Name:SYNNOTT, SCOTT ARTHUR (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ARTHUR
Last Name:SYNNOTT
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 1:1290 AUBURN GROVE LN
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20194-1108
Mailing Address - Country:US
Mailing Address - Phone:703-471-6717
Mailing Address - Fax:
Practice Address - Street 1:11503 SUNRISE VALLEY DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1505
Practice Address - Country:US
Practice Address - Phone:703-860-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010062671223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics