Provider Demographics
NPI:1801633359
Name:ALDIE SMILES, PLLC
Entity type:Organization
Organization Name:ALDIE SMILES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:571-463-1184
Mailing Address - Street 1:24560 SOUTHPOINT DR STE 370
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-3513
Mailing Address - Country:US
Mailing Address - Phone:571-463-1184
Mailing Address - Fax:
Practice Address - Street 1:24560 SOUTHPOINT DR # 370
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-3510
Practice Address - Country:US
Practice Address - Phone:571-463-1184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty