Provider Demographics
NPI:1821213984
Name:LANA SOULES D.D.S., INC.
Entity type:Organization
Organization Name:LANA SOULES D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOULES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-787-3585
Mailing Address - Street 1:112 ELDEN ST
Mailing Address - Street 2:SUITE S
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4874
Mailing Address - Country:US
Mailing Address - Phone:703-787-3585
Mailing Address - Fax:703-787-9887
Practice Address - Street 1:112 ELDEN ST
Practice Address - Street 2:SUITE S
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4874
Practice Address - Country:US
Practice Address - Phone:703-787-3585
Practice Address - Fax:703-787-9887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty