Provider Demographics
NPI:1740376193
Name:LEON SAKERS, CARLA (DDS)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:LEON SAKERS
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 1:5239 BALLYCASTLE CIR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5536
Mailing Address - Country:US
Mailing Address - Phone:410-371-4788
Mailing Address - Fax:
Practice Address - Street 1:14102 SULLYFIELD CIR
Practice Address - Street 2:SUITE 500
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1610
Practice Address - Country:US
Practice Address - Phone:703-378-4004
Practice Address - Fax:703-378-6921
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014112111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice