Provider Demographics
NPI:1740300904
Name:FONTES, FERNANDA GEAQUINTO (DDS)
Entity type:Individual
Prefix:DR
First Name:FERNANDA
Middle Name:GEAQUINTO
Last Name:FONTES
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 1:4229 LAFAYETTE CENTER DR STE 1400
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1267
Mailing Address - Country:US
Mailing Address - Phone:703-378-2000
Mailing Address - Fax:703-378-2400
Practice Address - Street 1:4229 LAFAYETTE CENTER DR STE 1400
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1267
Practice Address - Country:US
Practice Address - Phone:703-378-2000
Practice Address - Fax:703-378-2400
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014125971223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry