Provider Demographics
NPI:1356514483
Name:GLIKMAN, SANDRA MARCELA (DDS)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:MARCELA
Last Name:GLIKMAN
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 1:9661 MAIN ST # C
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-3739
Mailing Address - Country:US
Mailing Address - Phone:703-425-3737
Mailing Address - Fax:703-425-3762
Practice Address - Street 1:9621 FAIRFAX BOULEVARD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031
Practice Address - Country:US
Practice Address - Phone:703-271-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401441890122300000X
VA0401411890122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist